TUFTS   UNIVERSITY   LIBRARIES 


3  9090  014  532  200 


Webster  Family  Library  of  Veterinary  Medicine 
Cummings  School  of  Veterinary  Medicine  at 
Tufts  University 
200  Westboro  Road 
North  Grafton,  MA  01536 


HORSF     IN     SLINGS 


THE 


Principles  and  Practice 


OF 


VETERINARY   SURGERY. 


BY 


WILLIAM    WILLIAMS, 

F.R.C.V.S.,  F.R.S.E.,  Etc. 

EX-PRESIDENT  OF  THE  ROYAL  COLLEGE  OF  VETERINARY  SURGEONS  ;    PRINCIPAL,  AND  PROFESSOR  OF 

VETERINARY  MEDICINE  AND  SURGERY  AT  THE  NEW  VETERINARY  COLLEGE,  EDINBURGH  ; 

PROFESSOR  OF  VETERINARY  SURGERY  AND  EXAMINER  IN  AGRICULTURE  FOR  THE 

HIGHLAND  AND  AGRICULTURAL  SOCIETY  OF  SCOTLAND  ;    FOREIGN 

CORRESPONDENT  OF  THE  SOCIETE  CENTRALE  DE  MEDICINE 

VETERINAIRE  ;    AND  AUTHOR  OF  "  THE  PRINCIPLES 

AND  PRACTICE  OF  VETERINARY  MEDICINE." 


FOURTH   EDITION. 


NEW   YORK:    WILLIAM    R.    JENKINS, 

850  Sixth  Avenue. 
1882. 


753 


PRINTED  FOR  THE  AUTHOR  BY  EURNESS  &  COMPANY, 
AND  PUBLISHED  BY 

JOHN  MENZIES  &  CO.,  EDINBURGH  AND  GLASGOW. 

London, J.  &  A.  Churchill. 

New  York, W.  R.  Jenkins. 

Toronto, Carswell  &  Co. 


PREFACE  TO  THE  FOURTH  EDITION. 

The  Third  Edition  liavino-  become  exhausted,  a  Fourth  has 
been  issued.  The  Author  has  not  found  it  necessary  to  make 
any  alterations  or  additions  to  the  text. 

W.  W. 

Xew  Veterinary  College,  Edinburgh, 
Septemher  1882. 


PREFACE  TO  THE  THIRD  EDITIOX. 

The  reception  which  former  editions  of  this  work  have  met  with, 
lias  been  a  source  of  gratification  to  the  Author,  and  has 
encouraged  him  in  furtlier  efforts  to  promote  the  study  of 
Veterinary  Science.  "While  he  has  found  it  necessary  to  revise 
and  enlarge  the  companion  volume  on  Veterinary  Medicine,  a 
new  edition  of  which  has  been  simultaneously  issued,  nothing 
of  importance  has  transpired  in  the  sphere  of  Veterinary  Surgery 
to  necessitate  a  similar  revision  of  this  work ;  the  only  alteration 
made  being  a  slight  rearrangement  in  the  chapter  on  ^lelanosis. 

W.  W. 


New  Veterinary  College,  Edinburgh, 
Sejylember  1879. 


PKEFACE  TO  THE  SECOND  EDITION. 


The  success  of  the  First  Edition  of  this  work  has  imposed  upon 
nie,  thus  early,  the  agreeable  yet  onerous  duty  of  preparing  a 
Second  Edition. 

This  success  has  been  largely  contributed  to  by  the  demands 
for  the  work  from  America,  where,  it  is  gratifying  to  learn. 
Veterinary  Science  is  being  extensively  cultivated. 

In  embodying  in  this  edition  the  latest  information  on  the 
•various  subjects  discussed,  it  has  been  my  main  object  to  con- 
tinue to  deserve  the  approval  of  my  readers. 

The  chapters  on  Inflammation  have  been  carefully  revised, 
and  the  latest  opinions  and  theories  copiously  embodied. 

The  differences  of  opinion  regarding  the  diagnosis  of  Foot 
Eot,  and  Foot-and-Mouth  Disease  in  Sheep — as  exemplified  in 
the  evidence  of  Veterinary  Surgeons  in  cases  which  have  been 
tried  in  Courts  of  Law  since  the  issue  of  the  First  Edition — 
have  induced  me  to  treat  this  subject  at  considerable  length.  I 
trust  that  the  characteristic  differences  of  these  diseases  have 
been  so  clearly  brought  forward,  that  there  will  no  longer  be  any 
room  for  those  differences  of  opinion  which  at  present  obtain. 

The  chapters  on  Hernite  have  been  remodelled,  and  I  hope 
simplified.  Those  on  Skin  Diseases  and  their  treatment  con- 
siderably extended. 

In  addition  to  these  alterations  in  the  text,  the  Plates  illus- 
trative of  the  subjects  enlarged  upon,  have  been  increased  in 
number. 

In  preparing  this  edition,  I  have  received  valuable  assistance 
from  ]\Ir.  Broad,  of  Bath,  and  Mr.  Johnston,  my  Clinical 
Assistant,  to  both  of  whom  I  now  tender  my  thanks. 

W.  W. 

New  Vkterixary  College,  Edinbukgh, 
1st  December  1875. 


rEEFACE  TO  THE  FIRST  EDITION. 


The  aim  of  the  following  work  is  to  render  a  full,  and  at  tlie 
same  time  concise,  exposition  of  tlie  Pathology  of  tlie  Diseases 
— more  particularly  of  the  Surgical  Diseases — to  which  the 
Domestic  Animals  are  subject,  together  with  an  account  of  the 
principles  which  ought  to  regulate  their  management  and 
treatment. 

The  chapter  on  Inflammation  will  be  found  to  contain  the 
latest  information  ;  and  it  may  not  be  amiss  to  direct  attention 
to  what  is  said  regarding  the  formation  of  pus,  as  being  of 
importance  not  only  in  itself,  but  as  illustrative  also  of  the  mode 
of  formation  of  other  pathological  products. 

I  have  been  enabled,  from  the  ]\Iuseum  of  the  Edinburgh 
Veterinary  College,  which  is  rich  in  pathological  specimens — 
collected  by  my  distinguished  predecessor  and  teacher,  the  late 
Professor  Dick — to  furnish  numerous  illustrations  of  the  patho- 
logy of  bone,  woodcuts  of  which  will  be  found  throughout  the 
work.  Numerous  woodcuts  of  ^  drawings  from  microscopic 
preparations  have  also  been  inserted,  in  order  to  render  more 
clear  tlie  description  of  the  minute  anatomy  of  various  morbid 
Droducts.  Some  of  these  woodcuts,  as  will  be  seen  by  the 
explanatory  notes  appended,  have  been  obtained  from  various 
medical  works;  whilst  the  rest  are  original,  and  prepared 
from  specimens,  mostly  collected  by  myself,  and  now  in  my 
possession. 

Much  assistance  has  been  rendered  me  in  the  preparation  of 


VI  PREFACE  TO  FIRST  EDITION.     - 

these  microscopic  views  and  drawings,  by  my  colleague  Dr. 
Young,  and  Mv.  Yauglian,  one  of  my  own  students. 

I  venture  to  express  a  hope  that  this  work  will  be  found 
acceptable,  both  to  Practitioners  and  Students  of  Veterinary 
Science,  for  Avhom  it  has  been  specially  prepared. 

It  will  be  seen  by  the  professional  reader  that  it  contains 
much  matter  relating  to  human  pathology,  necessarily  intro- 
duced for  the  purpose  of  denoting  the  similarity,  or  identity, 
of  morbid  actions  in  man  and  the  lower  animals ;  and  I  have 
not  hesitated  to  make  quotations  from  the  works  of  various 
pathologists,  whose  names  are  duly  acknowledged. 

I  have  to  express  my  thanks  to  Professor  Bennett,  Dr. 
Eedfern,  Dr.  Chance  (the  translator  of  Yirchow),  Dr.  Arnott, 
and  Professor  Simonds,  for  the  use  of  their  plates;  to  Mr. 
Broad,  of  Bath,  for  many  valuable  suggestions  on  the  Diseases 
of  the  Feet ;  and  to  Mr.  Stevenson  Smith,  of  Edinburgh,  for  his 
careful  revision  of  the  section  on  Diseases  of  the  Skin. 

Veterinary  College,  Edinburgh, 
Jul)/  1872. 


CONTENTS. 


CHAPTER  L 
Inflammation. 


PAGK 


Definicion— Pathology— Phenomena— Causes— Varieties  due  to  Causation 
—Local  Symptoms— Chronic  Inflammation— Terminations— Resolu- 
tion—Efflision,  ......  '^-^^ 

CHAPTER  II. 

Terminations  of  Inflammation — continued. 

Suppuration — Acute  Abscess — Diffuse  Suppuration — Superficial  Suppura- 
tion— Comparison  between  Pus,  Mucus,  and  Epithelium — Pyogenic 
Fever  or  Strangles — Pyaemia — Re-absorption  of  Pus— Formation  of 
Sinuses — Ulceration — Varieties  and  Treatment  of  Ulcers — Morti- 
fication. .  .  .  .  .  ...  31  -i>9 

CHAPTER  III. 

Symptoms  of  Inflammation. 

General  Symptoms  of  Inflammation — Inflammatory  Appearances  of  the 
Blood — Treatment  of  Inflammation — Treatment  of  Chronic  Inflam- 
mation, .......  60-// 

CHAPTER  IV. 

Fractures  and  Diseases  of  Bones. 

Causes  of  Fracture — Symptoms — Modes  of  Union — Treatment  of  Frac- 
tures— Compound  Fractures — Separation  of  Epiphyses — False  Joints 
and  Non-Union,         ......  78-90 

CHAPTER  V. 

Particular  Fractures. 

Fractures  of  Inferior  Maxilla — Fractures  of  Anterior  Maxilla  and  of  other 
Facial  Bones — Fractures  of  Cranial  Bones — Fracture  by  "Counter 
Stroke" — Concussion  of  the  Brain — Hernia  Cerebri,  .  91-116 


Vm  CONTENTS. 

CHAPTER  VI. 

Particulab  Fractures — continued, 

PAGE 

Fractures  of  the  Vertebrae — On  Broken  Back — Fracture  of  the  Sacral  and 
Coccygeal  Bones — Fracture  of  the  Pelvic  Bones — Fracture  of  the 
Femur — Fracture  of  Tibia — Fracture  of  the  Tarsal  and  Metatarsal 
Bones,  .......  117-130 

CHAPTER  VII. 

Particular  Fractures — continued. 

Fractures  of  Scapula — Humerus — Condyles — Olecranon — Radius — Ulna 
— Trapezium,  Carpal,  Metacarpal,  and  Sesamoid  Bones — "Split 
Pasterns" — Navicular  and  Pedal  Bones — Broken  Ribs — Luxations — 
Case  of  Dislocation  of  Third  Cervical  Vertebra,         .  .  131-146 

CHAPTER  VIII. 

Diseases  or  the  Bones  and  Articulations. 

Classification  of  the  Bones — Ostitis — Sore  Shins — Splints — Peculiarity  of 

Splint  Lameness — Scrofulous  Ostitis,  .  .  .  148-164 

CHAPTER  IX. 

Diseases  of  the  Bones  and  Articulations — continued. 

Ulceration — Caries — Necrosis — Central    and    Subperiostal    Suppuration 

— Abscess  in  the  Substance  of  a  Bone,  .  .  .  lGo-177 

CHAPTER  X. 

Non-Inflammatory  Diseases  of  Bones. 

Rickets — Mollities  Ossium — Osteo-Porosis — Fragilitus  Ossium — Osteo- 
sarcoma— Effects  of  Mercurial  Poisoning  on  Bones,  .  178-201 

.     CHAPTER  XL 

Diseases  of  the  Joints. 

Classification  of  the  Joints — Anchylosis  of  the  Vertebrae — Acute  Syno- 
vitis— Chronic  Scrofulous  Synovitis — Calcification  of  the  Synovial 
Fringes — Rheumatoid  Arthritis — Kennel  Lameness — Morbid  Condi- 
tion of  Cartilage— Traumatic  Inflammation  of  Joints — Hydrops 
Articulorum — Anchylosis,      .....  203-229 

CHAPTER  XIL 
Lameness. 
Diagnosis — Definition — Signs — Causes — Congenital    Muscular   Atony — 


CONTENTS.  ix 


Methods  of  Examination — Sprains — Strains  of  Psose  Muscles — 
Chorea — Stringhalt — Shivering — Myositis —  Rheumatic  T/ameness — 
Emboli,  .......  231-252 

CHAPTER  XIII. 

Particular  Lamenesses. 

Shoulder  Lameness — Shoulder-Slip — Elbow  Lameness — Sprain  of  Radial 

or  Superior  Carpal  Ligament — Carpitis,  .  .  ,  253-268 

CHAPTER  XIV. 

Particular  Lamenesses — continued. 

Speedy  Cut — Broken  Knees — Sprain  of  Flexor  Tendons — Sjjrains  of 
Suspensory  Ligament — Sprain  of  Fetlock- Joint — Sesamoiditis  —  Ring- 
Bones,  .......  269-290 

CHAPTER  XV. 

Particular  Lamenesses — continued. 

Hip -Joint  Lameness — Sprain  of  Gluteal  Tendons,  or  Trochanteric  Lame- 
ness— Sprain  and  Atrophy  of  Crural  Muscles — Stifle- Joint  Lnmeness 
— Laceration  of  Flexor  Metatarsi  Muscle,         .  .  ,  291-298 

CHAPTER  XVI. 

Particular  Lamenesses — continued. 

Diseases  of  the  Hock — Bog-Spavin — Bone-Spavin — Conformation  of  Hock 
most  subject  to  Spavin — Thorough-Pin — Capped  Hocks — Injuries  to 
Gastrocnemii  Muscles — Curb,    ...  .  ,  .  299-316 

CHAPTER  XVIL 

Treatment  of  Lameness. 

Rest — Position  of  the  Limb — Removal  of  Shoes-  -High-Heeled  Shoe — 
Thin -Heeled  Shoe — Hot  and  Cold  Fomentations — Local  Bleeding — 
Purgatives — Counter-irritants — Blisters — Setons — Actual  Cautery — 
Theory  of  theii-  Action,  .  .    "         .  .  .  317-324 

CHAPTER  XVIII. 

Diseases  of  the  Feet. 

Preliminary  Observations  on  Shoeing — Foot  Lameness,  divided  into  three 
kinds  :  (1.)  Diseases  of  the  Bones  and  Cartilages;  (2.)  Diseases  of  the 
Horn-Secreting  Structures;  (3.)  Accidental  Injuries — Disease  of  the 
Pyramid  of  Os  Fed^s — Side-Bones — Navicular  Disease,  Theories  of 
— Causes,  Pathology,  and  Treatment — Neurotomy,  its  favourable 
and  unfavourable  Effects — Gelatinous  Degeneration  of  the  Navicular 
Bursa — Pathological  Anatomy — Comparison  to  White  Swelling,  325-355 


X  CONTENTS. 

CHAPTER  XIX. 

Diseases  of  the  Feet — continued. 

PACE 

Inflammation  of  the  Feet — Divisions  of  Laminitis — Pathological  Changes 

— Causes — Symptoms — Treatment — Mr.  Broad's  Treatment,  .  856-369 

CHAPTER  XX. 

Diseases  of  the  Feet — continued. 

Diseases  of  the  Horn-Secreting  Structures — "Villitis — Carbuncle  of  Coro- 
nary Band — False-Quarter — Sand-Crack — Horn  Tiimours — Seedy- 
Toe— Corns— Thrush— Canker,  ....  370-386 

CHAPTER  XXI. 

Diseases  op  the  Yy.y.T!— continued. 

Punctures  of  the  Feet  by  "  Gathered  Nails  "  and  by  "  Pricks  "  in  Shoe- 
ing— Importance  of  thoroughly  examining  Wounded  Feet  and  of 
giving  Exit  to  all  Discharges — Weak  Feet  liable  to  Injuries — 
— Quittor — Treatment — Foul  in  the  Foot  of  Horned  Cattle — Foot- 
Eot  in  Sheep,    .......  387-406 

CHAPTER  XXII. 

TUMOUES. 

Structure  and  Classification — ISIalignant  Tumours — Microscopic  Anatomy 
— Divisions — Scirrhus  or  Hard  Cancer — Soft  Cancers — Colloid — 
Medullary — Melanosis — Ephithelial  Cancer,      .  .  ,  408-426 

CHAPTER  XXIII. 

Benign  Tumours. 

Classification — Fibrous — Polypi — Indurated  Abscesses — Epidermic  Warts 
— Condylomata — Grapes — Lipomata — Neuromata — Enchondromata 
— Crusta-Petrosa — Calcareous  — Osteophytes — Osteo-Sarcoma — Cys- 
tic, Barren,  and  Proliferous  Cysts — Gaseous,  Serous,  Synovial,  and 
Mucous  Cysts — Capped  Elbow — Capi^ed  Hock — Ovarian  Cysts — 
Ranula — Bronchocele — Cutaneous  and  Hair-Bearing  Cysts — Cystic 
Disease  of  the  Facial  Sinuses — Dentigerous  or  Teeth  -  Bearing 
Cystb 427-447 

CHAPTER  XXIV. 

Wounds. 

Definition — Classification — Incised — Punctured — Lacerated — Contused — 
Gun-Shot — Poisoned — Treatment  of  Wounds — Sutures — Collodion — 
Styptic-Colloid — Shellac  Paste — Non-interference,      .  .  448-457 


CONTENTS.  xi 

CHAPTER  XXV. 

Wounds — continued. 

PAGa 
Gun  -Shot — Cannon  Balls — Wind  Contusions — Musket-Shot — Grape-Shot 
— Small-Shot — Consequences  of  Gun-Shot  Wounds — Wounds  of 
the  Abdominal  Parieties — Wounds  and  Bruises  having  Special  Names 
— Burns,  Scalds,  and  the  Effects  of  Cold — Poisoned  Wounds  — 
Speedy-Cut — Tread — Cutting  or  Brushing,      ,  ,  .  458-472 

CHAPTER  XXVI. 

Wounds — continued. 

Methods  of  Repair — Immediate  Union — Primary  Adhesion— Granulation 
— Secondary  Adhesion — Healing  under  a  Scab — Foi'mation  of  the 
Cicatrix,  and  Completion  of  the  Reparative  Process,     .  .  473-48-3 

CHAPTER  XXVII. 

Results  of  Wounds. 

Erj^sipelas,  Simple  and  Phlegmonous  —  Symptoms  and  Treatment  — 
Tetanus,  Idiopathic  and  Traumatic — Various  Forms  of — Symptoms 
—Pathology— Treatment,  .  .  .  .  ,  484-402 

CHAPTER  XXVIII. 

Diseases  and  Injukies  of  the  Facial  Region. 

Wounds  of  the  Lips — Tumours — Bruises  of  the  Mouth — ^Affections  of  the 
Buccal  Membrane — Sporadic  Aphthae — Paralysis  of  the  Lips — Open 
Parotid  Duct — Salivary  Calculi — Ptyalism — Ranula — Epulis — Glos- 
sitis— Ulcer  and  Induration  of  the  Tongue  in  Hoi-ned  Cattle— Para- 
lysis of  the  Tongue,       .  .  .  .  ,  .  493-503 

CHAPTER  XXIX. 

Diseases  and  Injuries  of  the  Facial  Region — continued. 

Parrot-Mouth — Irregularities  of  the  Teeth — Diseases  of  the  Alveolar  Pro- 
cesses— Caries  of  the  Teeth — Diseases  of  Dentition — Dental  Irrita- 
tion in  Young  Cattle — Dental  Cough  in  Young  Horses — Dentition 
Fever — Supernumerary  Teeth — Diseases  of  the  Facial  Sinuses — 
Ozoina,  or  Nasal  Gleet,  .  ,  .  .  .  504-527 

CHAPTER  XXX. 

Diseases  of  the  Pharynx,  CEsophagus,  &c. 

Post-Pharyngeal  Abscess — Pus  in  the  Guttural  Pouches — Pharyngeal 
Polypi — Choking,  Clinical  Records  of — OEsophagotomy — Dilatation 
and  Stricture  of  the  (Esophagus — Wind-Sucking  and  Crib-Biting,         528-541 


Xll  CONTENTS. 

CHAPTER  XXXI. 

Diseases  of  the  Eyes. 

PAGE 

Conjunctivitis —  Nebulie — Albugo —  Staphyloma — Ulcers  —  Glaucoma — 
Amaurosis — Strabismus — Ectropium — Entropium — Trichiasis — Dis- 
tichiasis — Warts — Wounds — Haws — Lachrymal  Fistula — Stricture — 
Parasites — Fungus  Hsematodes — Periodic  OiDhthalmia — Cataract — 
Eemoval  of  Eyeball — Dislocation  of  Eyeball — Melanosis  of  Humours 
— Examination  of  Eye  by  Catoptric  Test  and  by  the  Ophthalmoscope,    542-565 

CHAPTER  XXXIL 

Diseases  of  the  He^vd,  Neck,  Veins,  &c. 

Otorrhoea — External  Canker  of  the  Ear — Poll-Evil — Fistulous  Withers^ 
Circumscribed  and  Diffuse  Phlebitis — Thrombus — Varicose  Veins — 
Phlebolites — Entrance  of  Air  into  the  Veins,  .  ,  506-577 

*  CHAPTER  XXXIII. 

Diseases  of  the  Arteries  and  Lyjiphatics.  . 

Diseases  of  the  Arteries — Arteritis — Embohsm — Aneurism — True  Aneur- 
ism— The  Dissecting  Aneurism — False  Aneurism— Aneurismal  Varix 
— Varicose  Aneurism — Degeneration  of  the  Arterial  Coats — Cal- 
careous, Cartilaginous,  and  Fatty  Degeneration— Injuries  to  Arteries 
— Inflammation  of  the  Absorbents,        ....  578-595 

CHAPTER  XXXIV. 

Hernia,  &c. 

Reducible — Irreducible  and  Strangulated  Herniae— Umbilical  or  Exom- 

phalos — Ventral,  Inguinal,  and  Scrotal  Hernise — Gut-Tie  in  Cattle,    596  -622 

CHAPTER  XXXV. 

Diseases  of  the  Bladder,  External  Organs  of  Urination,  &c. 

Diseases  of  the  Bladder,  Vagina,  Vesiculse  Seminalis,  Mammary  Gland, 
&c. — Cystic  Calculi  in  the  Horse,  Ox,  Sheep,  and  Dog — Lithotomy 
— Lithotripsy — Lithotrity — Urethral  and  Preputial  Calculi — Sabul- 
ous ^Matter — Urethritis — Phymosis — Paraphymosis — Arariutation  of 
the  Penis — Vaginitis — Leucorrhoea — Mammitis,  .  .  623-641 

CHAPTER  XXXVL 

Castration. 

Castration — Precautions  to  be  observed  before  the  Operation  is  performed 
— Methods  of  Operating — Consequences  of  Castration — Swelling — 
Hernia — Scirrhous  Cord — Fistula  of  the  Scrotum — Peritonitis — Gan- 
grene— Tetanus — Paralysis — Amaurosis — Glanders  and  Farcy,  642-654 


CONTENTS.  xiii 

CIIAPTEE  XXXVII. 

Diseases  of  the  Skin. 

Pack 

Classifications  :  Willan  and  Bateman's,  Bennett's,  and  Buchanan's — Ery- 
thematous Inflammations — Clipping  Horses — Herpes — Urticaria,  G55-GCG 

CHAPTER  XXXVI] I. 

Diseases  of  the  Skin — continued. 

Definition — Division — Various  Forms  of  Eczema — Simplex — Kubrum — 
Lichen — Impetiginodes — Acute  and  Chronic  Grease — Elephantiasis 
-  -Crusta  Labialis — Treatment  of  Eczematous  Eruptions — Effects  of 
Carbolic  Acid  on  the  Dog,  .....  66ir-C78 

CHAPTER  XXXIX. 

Diseases  of  the  Skin — continued. 

I.  Squamous  Inflammation  of  the  Skin — Psoriasis — Pityriasis  — II.  Dis- 
ordered Sensibility  of  the  Derma — Prm'igo — III.  Inflammation  of 
the  Sebaceous  Follicles — Acne — Sitfasts — Treatment,  .  G79-GS4 

CHAPTER  XL. 

Diseases  op  the  Skin — continued. 

Scabies — Different  Varieties  of  Acari — Sarcoptes — Dermatodectes — Sym- 
biotes — Classification — Experiments  of  Bering,  Hertwig,  and  others 
as  to  the  Transmissibility  of  the  Mites  to  Man — Mange  in  the  Horse 
and  Ox — Scab  in  Sheep — Mange  in  the  Dog  and  Cat — Treatment  of 
Mange — Diseases  due  to  Epizoa— Poultry  L(jusiness — Fleas — Ticks — 
Bots— Maggots,  ......  G8i;-712 

CHAPTER  XLL 

Diseases  of  the  Skin — continued. 

Favus,  or  Honeycomb  Ring- Worm— Experiments  of  Gruby— The  Achoiion 
Schonleinii — The  Yellow  Crust  due  to  the  Exudation — Trans- 
missibility of  the  Disease  from  Animals" to  Man,  and  vice  versa — 
Tinea  Circinatus — The  Tricophyton  discovered  by  Malmsten — 
Identity  of  Favus  and  Tinea  Circinatus  —  Letter  from  Mr. 
M'Giilivray  of  Banff— Treatment  of  Ring- Worm,  .  •  713-721 


LIST  OF  ILLUSTEATIONS. 


PHOTO-LITHOGRAPHS. 

PAGE 

I.  Diseases  of  the  Bones  and  Articulations,  .  ,  .147 

II.  Diseases  of  the  Joints,        ......         202 

IT  I.  Anchylosis,  or  the  Stiffening  of  the  Joints,  .  .  .230 

IV.  Tumoiirs,   ........         407 

LITHOGRAPHS. 
Horse  in  Slings,    ......        Frontispiece 

ITiree  Views  of  Mr.  Walker's  Face  Cradle,  .  .  .      95-96 

WOODCUTS. 

FIG. 

1.  Web  of  Frog's  Foot,  showing  First  Stage  of  Inflammation,  .  7 

2.  Irregular  Contraction  of  Small  Vessels  in  the  Web  of  a  Frog's  Foot 

after  the  application  of  Stimuli,  ....  8 

3.  Parenchymatous  Keratitis,  .  .  .  .  .13 

4.  Inflammation  and  Gelatinous  Degeneration  succeeding  Neurotomy,        20 
.5.   Purulent  Granulations,     ......  32 

6.  Examples  of  Cells,  ......  32 

7.  Cells  from  Fresh  Catarrhal  Sputa,  ....  33 

8.  Pus -Corpuscles,     .......  33 

9.  Oblique  Fracture  of  the  Tibia,  with  External  (Ensheathing)  CaUus,  80 

10.  Fracture  of  Metatarsus,  showing  the  Plug  within  the  Medullary  Canal,  81 

11.  Indirect  Comminuted  Fracture  of  Basilar  Process  of  Occipital  and 

Sphenoidal  Bones,  .  .  .  .  .  .104 

12.  Fracture  of  Neck  of  Femur,  .  .  .  .  .126 

13,  14.  SpHt  Pasterns,       .  .  .  .  .  .  .136 

15,  16.   Fracture  of  Navicular  Bone,  .....         138 

17.  Trochlea  of  the  Femur,  showing  the  effects  of  Friction  from  Luxation 

of  Patella,  .......  143 

18.  Dislocated  Neck,  .  .              .              .             .              .             .145 

19.  Inferior  Extremity  of  Tibia  in  a  Healthy  Condition,          .  .         152 

20.  Inferior  Extremity  of  Tibia  in  a  State  of  Ulceration,         .  .         152 

21.  Sore  Shin,  .......         154 

22.  Compound  Splint,  ......         156 

23.  Ordinary  Splint,     .  .              .              .              .             .              .158 

24.  Instrument  for  Pyro- Puncture,     .....         159 


LIST  OF  ILLUSTRATIONS. 


XV 


25. 

26. 

27,  28. 

29,  30. 

31,  32. 

33-35. 

36. 

37,  38. 

39-41. 

42,  43. 

44. 

45. 

46. 

47. 

48. 

49. 

50. 

51. 
52,  53. 

54. 
55,  56. 

57. 

58. 

59. 
60. 
61. 
62. 

63-65. 
66. 
67. 
68. 
69. 
70. 
7L 
72. 
73. 
74. 

75. 
76. 
77. 

78. 

79. 

80-99. 
100. 
101. 


PAGE 

170 
171 
176 
178,  179 
185 


Necrosis  Totalis,    ...... 

Section  of  the  Bone  represented  in  Fig.  25, 

Abscess  in  Bone,    ...... 

Rickets,     ....... 

Osteo-Porosis  of  Cranio-Facial  Bones, 

Effects  of  ISIercury  on  Bones  of  Dog,         .  .  .201 

Healthy  Cartilage,  .  .  .  .  .  .215 

Diseased  Articular  Cartilage,         .  .  .  .  .216 

Diseased  Cartilage,  .  .  .  .  .  .217 

Eepair  of  Cartilage,  .         .  .  .  .  .  .221 

False  Ring-Bone,  ......         285 

High  Ring-Bone,  .  .  .  .  .  .286 

Low  Ring-Bone,    .......         287 

Ring-Bone  involving  the  Os  Suffraginis,  ....  287 

Disease  of  Trochanter  Major,        .....         292 

Rupture  of  Flexor  Metatarsi,        .  .  .  .  .297 

Bone-Spavin,  .......         302 

Astragali  united  to  show  the  Screw  Lines,  .  .  .         305 

Bone-Spavin,         .......         308 

Spring  Truss  for  Thorough-Pin  and  Bog-Spavin,  .  .         311 

Horse-Shoes,  .......         327 

The  Foot  prepared  for  the  r4hoe,    .  .  .  .  .327 

Ossification  of    the  Lateral  Cartilages  ;    Fracture  of  the  altered 

Structure  upon  one  Side,  .  .  .  .  .330 

Phalangeal  Bones  in  their  naturally  Oblique  Position,       .  .         337 

Position  of  Phalangeal  Bones  altered  by  a  Thick-Heeled  Shoe,     .         338 
Longitudinal  Sections  of  Four  Navicular  Bones,  .  .  .343 

External  Appearance   of  Inferior  Articulating   Surfaces  of  four 

Navicular  Bones,  .  .  .  .  .  .344 

Ulceration  of  Cartilage,     .  .  .  .  .  .346 

Effects  of  Neurotomy,       .  .  .  .  .  .352 

Section  of  the  Foot  with  its  various  Parts  in  a  healthy  Condition,         358 
Formation  of  a  Horny  Exudate  at  the  Toe,  .  .  .         358 

Ribbed  Appearance  of  Foot  after  Laminitis,  .  .  .         359 

Absorption  of  Inferior  Edge  of  Os  Pedis,  .  .  .         359 

Advanced  Atrophied  Condition  of  Os  Pedis,  .  .  .         360 

Mr.  Broad's  Shoe,  .  .  .  .  .  .367 

Horny  Foot,  showing  Horn  Tumoiir,         ....         378 

Pedal  Bone   of  same  Foot,  showing-  a  Cavity  at   its  Toe  corre- 
sponding to  the  Horn  Tumour  in  Fig.  73,  .  .  .         378 
Bony  Spiculse  on  Plantar  Surface  of  Os  Pedis,      .             .             .         381 
Bistouri  Cache,     .             .             .              .             .             .             .390 

Confirmed  Stage  of  the  First  Form  of  Foot- Rot,  .  .  .400 
Condition  of  Internal  Wall  of  Digit  in  an  Early  Stage  of  Foot- 
Rot,       -  .         400 

Condition  of  a  Foot  four  weeks  after  the  Febrile  Stage  of  Foot- 

and-Mouth  Disease,       ......         402 

Microscopic  Anatomy  of  Cancer,  .  .  .  .  415-419 

Perpendicular  Section  of  an  Accuminated  Condyloma,      .             .         430 
Fat  Cells, 431 


XVI 


LIST  OF  ILLUSTRATIONS. 


FIG. 

102-104. 
105. 
106. 
107. 
108. 
109. 
110. 

111. 

112. 

113. 

114. 

115. 

116. 
117-119. 

120. 

121. 

122. 

123. 

124. 

125. 

126. 

127. 

128. 

129. 
130-132. 

133. 

134. 

135. 

136. 

137. 
138. 
139. 


PAGB 

Enchondroma,      .....,,         434 

Crusta-Petrosa  Tumour,  .....         435 

Development  of  Teeth,     ......         446 

Diagram  of  Development  of  Dentigeroiis  Tumour,  .  .         447 

Vertical  Section  of  a  Granulating  Sore,  ....         479 

Speculum  Oris,     .  .  .  .  .  .  .511 

Skull   cut   open    to   show,  the    situation  of   Bony    Partition   of 

Superior  Maxillary  Sinus,  .  .  .  .  .519 

Aneurism  of  the  Posterior  Aorta,  .  .  .  .582 

Inguinal  Hernia,  .  .  .  .  .  „         603 

Scrotal  Hernia,    .......         606 

Clams  for  Castration,       .  .  .  .  .  .644 

Torsion  Forceps,  .......         645 

Sarcoptes  Hippopodus,     ......         672 

Sarcoptes  Hominis  (Acarus  Scabie),  ....         687 

Sarcoptes  Equi,  .  .  .  .  .  .688 

Dermatodectes  Equi,        .  .  .  .  .  ,690 

Symbiotes  Equi,  ......         691 

Dermatodectes  Bovis,       .  .  .  .  .  .694 

Symbiotes  Bovis,  ......         695 

Dermatodectes  Ovis,   .     .  .  .  .  .  .         696 

Sarcoptes  Ovis,  from  above,  .....         699 

Sarcoptes  Ovis,  from  beneutli,      .....  699 

Sarcoptes  Suis,     .  .  .  .  .  .  .         700 

Sarcoptes  Canis,  .......         700 

Three  Follicles  of  the  Skin  of  the  Dog,  containing  Entozoa,         .         701 
Sarcoptes  Cati,     .  .  .  .  .  .  .705 

Branches  of  Achorion  Schonleinii,  .  .  .  .714 

Fragments  of  the  Branches  more  highly  developed,  .  .  714 

Thalli,  Mycelia,  and  Sporidia  of  the  Achorion  Schonleinii,  showing 

the  Mode  of  Reproduction,        .  .  .  .  .  714 

Isolated  Crusts  of  Favus,  .  .  .  .  .716 

Hairs  containing  Branches  of  the  Achorion  Schonleinii,  .         717 

Microscopic  Appearance  of  Ring-worm  Crust  after  the  addition  of 

Liquor  I'otassse,  ......         721 


THE 

PRINCIPLES   AND   PRACTICE 


OF 


VETERINAEY    SURGERY. 


CHAPTER  L 

INFLAMMATION. 

DEFINITION — PATHOLOGY — PHENOMENA — CAUSES — VARIETIES  DUE  TO 
CAUSATION LOCAL  SYMPTOMS — CHRONIC  INFLAMMATION — TER- 
MINATIONS— RESOLUTION EFFUSION. 

The  process  of  inflammation  is  the  most  important  of  all  morbid 
actions  and  conditions. 

It  has  been  variously  defined  by  different  investigators,  ac- 
cording to  what  they  conceived  it  to  be.  Thus  Hunter  says 
it  is  simply  an  increased  action  of  the  vessels.  In  Mr.  Syme's 
opinion,  it  is  "a  perverted  action  of  the  capillary  system,  generally 
attended  by  heat,  redness,  pain,  and  swelling."  Dr.  Alison  de- 
scribes it  as  "  a  peculiar  perversion  of  nutrition  or  of  secretion ; " 
and  Dr.  Aitken  defines  it  as  "  a  complex  morbid  process  charac- 
terised (1.)  by  a  suspension  of  the  concurrent  exercise  of  function 
among  the  minute  elements  of  the  tissue  involved ;  (2.)  by 
stagnation  of  the  blood,  and  abnormal  adhesiveness  of  the  blood 
discs  in  the  capillary  vessels  contiguous  to  the  tissue  elements 
whose  functions  are  suspended ;  (3.)  by  contraction  of  the 
minute  arteries  leading  to  the  capillaries  of  the  affected  part, 
with  subsequent  dilatations  and  paralysis  of  the  contractile 
tissue  of  the  affected  blood-vessels."  Dr.  Burdon  Sanderson 
defines  it  to  be  "  a  succession  of  changes  which  occur  in  a 


INFLAMMATION. 


living  tissue  when  it  is  injured,  provided  that  the  injury  is  not 
of  such  degree  as  at  once  to  destroy  its  structure  and  vitality." 

If  I  were  to  attempt  to  give  a  definition  of  inflammation,  I 
would  say  that  it  is  a  perverted  nutrition  of  a  living  part,  the 
effect  of  irritation  or  injury. 


PATHOLOGY. 

If  a  non-vascular  structure — the  cornea,  for  example — be 
excised  in  the  following  manner,  as  recommended  by  Professor 
von  Eecklinghausen,  changes  which  are  identical  with  the 
earliest  of  the  inflammatory  process  may  be  observed. 

"  The  anterior  chamber  is  first  punctured  so  as  to  let  out  a 
drop  of  aqueous  humour,  which  is  placed  on  the  object-glass ; 
the  cornea  is  then  excised  and  placed  in  the  drop  with  Desce- 
met's  membrane  uppermost.  The  preparation  thus  obtained  is 
examined  without  a  cover-glass,  in  a  closed  chamber  in  which 
the  air  is  saturated  with  moisture,  so  that  no  evaporation  can 
take  place,  and  consequently  no  alteration  in  the  density  of  the 
liquid  in  which  the  cornea  is  immersed.  The  healthy  cornea 
is  absolutely  transparent,  and  when  it  is  examined  under  the 
microscope,  in  the  manner  described,  no  structure  can  be  dis- 
tinguished. This  homogeneity,  so  essential  to  the  function  of 
the  cornea,  is  a  condition  inseparable  from  life ;  if  the  observa- 
tion is  continued  tiU  the  tissue  begins  to  die,  its  structural 
elements  gradually  come  into  view — first  the  epithelia,  then 
the  lymphoid  elements  proper  to  the  tissue,  then  the  cornea 
corpuscles.  The  explanation  of  the  fact  is,  that  whereas  in  life 
the  elements  of  which  the  cornea  is  formed  affect  light  exactly 
in  the  same  degree,  their  respective  refractive  powers  are  slightly 
altered  in  the  act  of  dying. 

"  If  a  cornea  is  examined  in  the  same  way,  which  has  been 
irritated  a  quarter  of  an  hour  before  by  the  application  of  a 
point  of  caustic  to  its  surface,  the  conjunctival  epithelial  layer 
can  at  once  be  distinguished,  along  with  a  few  leucocytes, 
underneath  and  among  the  epithelial  elements.  If  an  hour  or 
two  has  elapsed,  the  proper  cornea  corpuscles  are  visible,  as 
dark  stellate  or  spindle-shaped  spots  on  a  transparent  ground. 
Of  these  some  are  homogeneous,  and  can  be  distinguished  from 
the  surrounding  substance  by  a  slight  difference  of  shade.     In 


PATHOLOGY.  3 

otliers,  wliich  are  finely  granular,  the  processes  or  rays  are  sub- 
ject to  slight  variations  of  contour.  These  amoeboid  movements 
of  the  rays,  although  very  sluggish  as  compared  with  those  of 
young  protoplasm  in  general,  are  rendered  much  more  active  by 
subjecting  the  preparation  to  a  stream  of  blood  serum ;  for  which 
purpose  Professor  Strieker  employs  the  serum  of  the  same  animal 
which  has  furnished  the  cornea." 

From  the  above  we  learn  that  the  application  of  an  irritant 
produces  changes  similar  to  those  which  take  place  in  a  structure 
when  first  removed  from  the  influence  of  vitality,  and  that  in 
so  far  it  simulates  the  first  ;post  mortem  changes.  In  a  vascular 
structure  the  alterations  of  nutrition  which  result  from  the  ap- 
plication of  an  irritant  are  as  described  in  the  following  pages. 

It  must  be  borne  in  mind  that  the  blood  is  composed  of  a 
solid  and  a  fluid  portion.  The  fluid,  liquor  sanguinis,  com- 
posed of  albumen,  the  constituents  of  the  fibrine,  water,  and 
various  salts  in  solution ;  the  solid,  of  two  kinds  of  corpuscles, 
the  white  and  the  red.  The  red  corpuscles  move  rapidly  along 
in  the  centre  of  the  stream  of  blood  in  a  small  vessel ;  while  on 
either  side,  and  close  to  the  walls  of  the  vessel,  there  is  a  clear 
space  called  the  lymph  space,  containing  liquor  sanguinis  and 
a  few  white  globules,  which  move  much  more  slowly  than  the 
blood  in  the  centre  of  the  stream. 

The  fluid  part  of  the  blood  is  that  chiefly  concerned  in  nutri- 
tion. It  contains  the  nutritive  elements  in  solution,  and  is 
absorbed  by  the  various  textures.  The  capillaries  consist  of  a 
single  coat  of  protoplasm,  so  that  the  nutritive  material  can 
easily  pass  out  of  them,  and  nutrition  is  carried  on  entirely  in 
the  tissues  which  fill  up  the  spaces  between  the  capillaries. 
Every  tissue  has  an  inherent  power  of  attracting  and  selecting 
from  the  blood — which,  be  it  remelnbered,  flows  slowly  at  the 
side  of  the  vessel — those  constituents  best  suited  for  its  nourish- 
ment. 

From  this  it  will  be  seen  that  the  fluid  part  of  the  blood  is 
continually  transuding  through  the  walls  of  its  vessels,  for  the 
purpose  of  nourishing  the  tissues.  A  perversion  of  this,  with  a 
rapid  transformation  of  the  transuded  material,  and  an  altered 
mode  of  the  growth  of  the  elements  of  the  inflamed  texture,  con- 
stitute the  inflammatory  process.  When  the  tissue  is  irritated, 
lymph  is  produced  in  such  abundance  that  the  lymphatics  are 


4  INFLAMMATION. 

unable  to  convey  it  away ;  it  accumulates  in  the  part,  forming 
the  inflammatory  exudate. 

Eeasoning  upon  the  foregoing,  one  is  tempted  to  conclude 
that  inflammation  is  characterised  by  an  increased  nutrition  of 
the  part ;  but  such  is  not  the  case.  During  all  the  processes 
of  inflammation  there  is  no  such  thing  as  an  increased  forma- 
tion of  the  natural  structures  of  the  inflamed  part — they  are 
not  even  maintained;  and  it  is  only  after  the  inflamma- 
tion has  subsided  that  there  is  an  increased  formation  of 
some  of  the  tissues,  as  the  areolar,  the  bony,  and  the  horny 
structures. 

Whilst  the  inflamed  structure  itself  suffers  deterioration,  the 
process  of  inflammation  is,  however,  characterised  by  a  produc- 
tion of  lowly  organized  material. 

Having  now  endeavoured  to  show  what  I  conceive  to  be  the 
essential  nature  of  inflammation,  viz.,  a  perverted  nutrition,  con- 
sequent on  injurious  irritation  of  tissues,  I  shall  call  attention 
to  the  series  of  experiments  that  have  been  made  to  demonstrate 
the 

PHENOMENA  OF  INFLAMMATION. 

The  latest  observers  state  that  the  microscopically  visible 
changes  that  occur  in  a  transparent  vascular  membrane  of 
an  animal,  such  as  the  web  of  the  frog's  foot,  differ  con- 
siderably, according  to  the  irritant  employed.  A  weak  solution 
of  caustic  soda,  dilute  sulphuric  acid,  &c.,  produce  dilatation,  flrst 
of  the  arteries,  and  subsequently  of  the  capillaries,  with  marked 
acceleration  of  the  circulation,  followed  by  arterial  contraction 
and  capillary  anaemia.  But  liquor  ammonise,  and  carbonate  of 
ammonia  in  substance,  appear  always  to  occasion  a  certain  de- 
gree of  primary  arterial  contraction,  which  begins  in  one  or  two 
minutes  after  excitation,  and  is  attended  with  retarded  flow 
jf  blood  through  the  capillaries ;  distension  of  the  branches 
given  otf  by  the  artery  nearer  the  heart,  and  increased  activity 
of  circulation  in  the  neighbourhood  of  the  irritated  part.  This 
state  of  things  lasts  for  an  hour  or  two,  and  is  succeeded  by 
dilatation  and  acceleration.  Croton  oil  appears  to  occupy  an 
intermediate  position  between  the  first-named  stimulants  and 
ammonia;  for  while  it  always  gives  rise  to  acceleration  of 
the   flow  of   blood  as  a  primary  result,  this    change  is  some- 


PHENOMENA.  5 

times  associated  with  widening,  sometimes  with  narrowing,  of 
the  arteries. 

When  the  mesentery  of  the  frog  is  spread  out  and  examined 
microscopically,  the  first  change  which  is  observed  in  the  circu- 
lation, as  a  result  of  the  exposure  to  air,  consists  in  dilatation 
and  increase  in  the  lengtli — manifested  by  more  or  less  contor- 
tion— of  the  arteries.  The  dilatation  begins  immediately,  and  is 
preceded  by  no  contraction.  It  is,  however,  progressive ;  the 
diameter  of  the  artery  gradually  increases  for  ten  or  twelve 
hours,  at  the  end  of  which  period  it  is  often  twice  as  great  as 
it  was  before :  having  thus  attained  its  maximum,  its  size  re- 
mains unaltered  for  many  hours.  This  dilatation  of  the  arteries 
is  followed  by  a  similar  change  in  the  veins ;  but  inasmuch  as 
there  is  a  considerable  interval  between  the  two  events,  a  time 
occurs  at  which  the  arteries,  instead  of  being  sensibly  smaller  than 
the  veins  which  correspond  to  them,  far  exceed  them  in  diameter. 

Along  with  these  changes,  the  rate  of  movement  of  the  blood 
is  also  altered.  At  the  beginning  of  the  process  the  circulation 
is  quicker  than  natural.  Although  the  two  changes  go  on  at 
the  same  time,  the  acceleration  cannot  be  regarded  as  a  result 
of  the  increase  of  calibre ;  for  the  inevitable  consequence  of 
dilatation  would  be  diminution,  not  increase,  of  the  rate  of 
movement,  supposing  the  activity  of  the  heart  and  the  resistance 
opposed  by  the  capillaries  of  distribution  to  be  the  same.  The 
absence  of  any  relation  between  the  two  is  still  more  clearly 
shown  by  what  is  observed  at  a  later  period ;  for  whereas, 
on  the  one  hand,  as  has  been  already  stated,  the  dilatation  lasts 
fur  many  hours,  the  acceleration  is  confined  to  the  first  stage  of 
the  process.  The  rate  of  movement  soon  becomes  normal,  and 
this  is  shortly  followed  by  a  change  in  the  opposite  direction ; 
so  that  by  the  time  the  arteries  are  fully  dilated,  the  circulation 
is  much  slower  than  it  was  originally. 

Many  experiments  have  been  made  with  the  view  of  account- 
ing for  the  dilatation  and  contraction  of  the  arteries  and  capillary 
blood-vessels,  and  the  most  important  results  of  these  are — that 
division  of  a  vasa  motor  nerve  produces  congestion  of  all  the 
tissues  to  which  it  is  distributed ;  that  excitation  by  the  inter- 
rupted electrical  current,  or  by  mechanical  means,  produces  con- 
striction of  the  minute  arteries  presided  over  by  the  irritated 
nerve,  and  consequent  anaemia ;  that  excitation  of  a  sensory  nerve 


6'  INFLAMMATION. 

produces  increased  activity  of  the  capillary  circulation  in  the 
part  in  which  the  nerve  originates ;  and  finally,  that  all  arteries 
manifest  alternating  states  of  contraction  and  dilatation — move- 
ments independent  of  those  of  the  heart,  and  of  breathing — and 
ceasing  when  the  vessels  are  paralyzed  by  division  of  their  nerves. 

Eeference  to  the  effect  of  croton  oil  shows  that  acceleration 
of  the  flow  of  the  blood  through  the  vessels  of  the  irritated 
part  is  sometimes  associated  with  widening,  sometimes  with 
narrowing  of  the  arteries;  and  in  order  to  judge  whether  the 
acceleration  in  the  one  condition  is  of  a  similar  or  of  an  opposite 
nature  to  what  it  is  in  the  other,  investigators  have  observed 
both  conditions  simultaneously  in  the  same  part.  If,  for 
example,  in  the  web  of  the  frog's  foot  the  acceleration  due  to 
electrical  excitation  of  the  central  end  of  the  sciatic  nerve  is  of  the 
same  nature  as  inflammation,  we  should  expect  it  to  be  increased 
by  local  irritation ;  and,  conversely,  the  effect  of  irritation,  if 
already  existing,  to  be  heightened  by  exciting  the  nerve.  The  very 
careful  experiments  of  Dr.  Eiegel  show  that  it  is  so.  Having 
found  that  after  section  of  the  sciatic  nerve  the  effects  of  irritation 
were  slightly  retarded,  but  otherwise  unmodified,  he  repeated  the 
observation  in  another  animal,  excited  the  central  end,  and  then 
applied  croton  oil  to  both  webs.  On  the  injured  side  the 
accelerating  effect  of  the  croton  oil  lasted  much  longer  than  on 
the  other,  so  that  at  the  time  stasis  had  already  set  in  on  the 
sound  side,  the  circulation  was  going  on  more  briskly  than 
natural  on  the  injured  side. — (BuRDON  Sanderson.) 

From  the  foregoing  observations,  the  reader  will  gather  that 
acceleration  of  the  flow  of  blood  through  the  part  is  the  only 
constant  fact  observable,  whether  the  cause  be  the  reflex  electrical 
stimulation  of  a  nerve,  or  the  direct  irritation  of  the  part  by 
agents  which  induce  either  contraction  or  dilatation. 

In  all  forms  of  inflammation  of  sufficient  intensity,  the  circu- 
lation, after  a  varying  period  of  excitation,  becomes  retarded. 
The  current  then  ceases,  the  vessels  at  the  same  time  become 
greatly  distended,  and  the  blood  globules  adherent  to  certain 
parts  of  the  sides  of  the  vessels,  and  to  each  other,  so  that 
their  individual  forms  can  no  longer  be  distinguished.  In  some 
cases  the  vessels  have  fusiform  dilatations  of  their  whole 
circumference  at  certain  points  of  tlieir  course,  or  at  short 
intervals  pouches  sprout  from  the  sides  of  their  walls.     These 


PHENOMENA.     '  7-- 

pouches  are  not,  however,  peculiar  to  the  inflammatory  state, 
and  they  have  been  ascribed  to  structural  derangement  of  the 
walls  of  the  vessels,  in  consequence  of  which  they  cannot  present 
an  equable  resistance  to  the  column  of  blood,  and  consequently 
the  blood  becomes  extravasated  into  the  surrounding  textures. 

Some  have  affirmed  that  constriction  of  the  vessels  never 
takes  place  prior  to  their  ddatation.  This,  as  already  ex- 
plained, has  arisen  from  the  kind  and  strength  of  the  irritant 
used  by  these  observers ;  whilst  others  state  that,  during  con- 
traction, the  blood  is  seen  to  flow  more  rapidly  through  them, 
and   that    this    is    explained    by    the    well-known    fact    that 


Fig.  1. — An  exact  copy  of  a  portion  of  the  web  in  the  foot  of  a  young  frog,  after 
a  drop  of  strong  alcohol  had  been  placed  upon  it.  The  view  exhibits  a  deep-seated 
artery  and  vein,  somewhat  out  of  focus  ;  the  intermediate  or  capillary  plexus  run- 
ning over  them,  and  pigment  cells  of  various  sizes  scattered  over  the  whole.  On 
the  left  of  the  figure  the  circulation  is  still  active  and  natural.  About  the  middle 
it  is  more  slow,  the  column  of  blood  is  oscillating,  and  the  corpuscles  crowded 
together.     On  the  right,  congestion,  followed  by  exudation,  has  taken  place. 

a.  A  deep-seated  vein,  partially  out  of  focu^.  The  current  of  blood  is  of  a  deeper 
colour,  and  not  so  rapid  as  that  in  the  artery.  It  is  running  in  the  opposite  direc- 
tion. The  lymph  space  on  each  side,  filled  with  slightly  yellowish  blood  plasma,  is 
very  apparent,  containing  a  number  of  coloiurless  corpuscles^  clinging  to,  or  slowly 
moving  along,  the  sides  of  the  vessel. 

b.  A  deep-seated  artery,  out  of  focus,  the  rapid  current  of  blood  allowing  nothing 
to  be  perceived  but  a  reddish-yellow  broad  streak,  with  lighted  spaces  at  the  sides. 

Opposite  c,  a  laceration  of  a  capillary  Vessel  has  produced  extravasation  of  blood, 
which  resembles  a  brown  spot. 

At  d,  congestion  has  occurred,  and  the  blood  corpuscles  are  apparently  merged 
in  one  semi-transparent  reddish  mass,  entirely  filling  the  vessels.  The  spaces  of  the 
web  between  the  capillaries  are  rendered  thicker  and  le>s  transparent,  partly  by 
the  action  of  the  alcohol,  partly  by  the  exudation.  This  latter  entirely  fills  up  the 
spaces,  or  only  coats  the  vessels.     200  diameters. — (Bennett.) 

liquids  flow  more  rapidly  through  a  narrowed  tube.     This  is  not 


8 


INFLAMMATION. 


the  case,  for,  as  Paget  observes,  "  As  the  vessels  are  contracting, 
the  blood  flows  in  them  more  slowly,  or  begins  to  oscillate ;  nay, 
sometimes,  I  think,  even  before  the  vessels  begin  visibly  to 
contract,  one  may  observe  that  the  blood  moves  more  slowly 
in  them,  as  if  this  were  an  earlier  effect  of  the  stimulus ;  nor 
have  I  seen  (what  has  been  commonly  described)  the  acceleration 
of  the  flow  of  blood  in  the  contracting  vessels."  He  again 
remarks — "  It  has  been  commonly  said,  that  as  the  vessels  con- 
tract, therefore  the  movement  of  blood  becomes  more  rapid  in 
them,  as  when  a  river  entering  a  narrow  course  moves  through 
it  with  a  faster  stream,  and  that  then,  as  the  vessels  widen,  so 
the  stream  becomes  in  the  same  proportion  slower.  But  this 
is  far  from  true  ;  the  stream  becomes  slower  as  the  artery  or 
vein  becomes  narrowed  by  contraction,  and  then,  as  the  tube 
dilates,  the  stream  grows  faster,  and  then,  without  any  appreci- 
able change  of  size,  it  may  become  slower  again,  till  complete 
stagnation  ensues  in,  at  least,  some  part  of  the  blood-vessels." 
Now,  the  reader  must  remember  that  arteries  are  supplied  with 
muscular  or  contractile  power,  and  when  they  are  acted  upon  by 
any  influence  which  causes  a  contraction  of  their  muscular  coat, 
they  must,  of  course,  become  narrower,  inasmuch  as  the  muscular 
cells  lie  in  rings  around  them.  The  consequence  then  is,  that 
less  blood  penetrates  the  part  of  the  body  supplied  by  such 
arteries.     The  more  muscular  an  artery  is,  the  more  lasting  and 


Fig.  2. — Irregular  contraction  of  small  vessels  in  the  web  of  a  frog's  foot  after 
the  appHcation  of  stimuU. — (Wharton  Jones.) 

forcible  is  the  contraction,  and  the  greater  the  obstruction  ex- 


PHENOMENA.  9 

perienced  by  the  current  of  blood.  In  the  smaller  vessels  the 
contraction  is  rapidly  succeeded  by  dilatation,  which  continues 
for  a  longer  or  shorter  period.  When  an  artery  is  really  in 
action  it  gives  rise  to  no  hyperaemia ;  on  the  contrary,  the  more 
active  the  vessel,  the  less  blood  will  pass  through  it.  The  con- 
traction of  the  vessels  is  very  irregular,  as  will  be  seen  from  tlie 
preceding  engraving  (Fig.  2). 

If  contraction  of  the  vessel  be  the  first  change  observed,  it  is 
succeeded  by  dilatation,  and,  as  already  stated,  the  stream  of 
blood  may  become  faster.  Then,  without  any  change  being 
observed  in  the  size  of  the  vessels,  it  becomes  slower,  oscillates, 
and  finally  completely  stagnant,  constituting  stasis  or  passive 
congestion. 

The  contraction  of  the  vessels  can  be  produced  by  the  appli- 
cation of  a  stimulus  to  the  nerves  supplying  them,  and  the 
relaxation  by  cutting  these  nerves.  From  this  we  conclude — 
and  the  fact  is  an  important  one — that  relaxation  of  the  mus- 
cular fibres  of  the  vessels  can  be  produced  by  paralysis  of  the 
nerves  that  supply  them,  or  by  an  interruption  of  the  nervous 
influence,  from  whatever  cause  it  may  proceed.  That  the  capil- 
laries have  the  power  of  contraction  has  been  demonstrated  by 
Professor  Lister,  wlio  has  shown  that  this  .contractility  is  de- 
pendent on  fusiform  (spindle-shaped)  cells,  which  have  the  power 
of  shortening  themselves,  and  which  run  transversely  round  the 
delicate  membrane  that  forms  the  walls  of  the  capillaries. 

The  stoppage  of  the  blood  (or  stasis)  has  now  to  be  accounted 
for,  and  this  is  difficult  of  explanation,  as  no  mechanical 
obstruction  has  ever  been  seen  to  present  itself.  If  there  is  no 
obstruction,  why  should  there  be  a  stoppage  ? 

Some  pathologists  have  asserted  that  the  vessels  become 
mechanically  plugged  up  by  the  red  corpuscles  adhering  to  the 
sides  of  them  (Boerhave)  ;  by  multiplication  of  the  colourless 
corpuscles,  and  by  change  in  the  specific  gravity  or  viscidity  of 
the  blood  in  a  part  (Wharton  Jones),  or  of  the  corpuscles  in 
particular  (Bruecke)  ;  obstruction  of  the  venous  circulation  (G. 
Eobinson)  ;  or  adhesiveness  of  the  blood  corpuscles  (Lister). 
These  opinions  have  been  combated  by  Professor  Bennett,  who 
says,  "That  the  blood  corpuscles  indeed  have  a  tendency  to 
aggregate  together  is  certain,  and  I  have  frequently  seen  what 
Mr.  Lister  has  described,  namely,  a  roll  of  them  projecting  from 


10  INFLAMMATION. 

a  side  vessel  into  a  large  one,  and  oscillating  in  the  current 
without  separating;  but  that  this  is  produced  by  a  viscous 
condition  of  these  bodies,  which  causes  their  surfaces  to  stick 
together,  as  he  appears  to  think,  is  negatived  by  the  fact  that 
not  unfrequently  I  have  seen  one  or  more  of  them  approach 
rapidly  a  vessel  in  the  inflamed  tissue  not  yet  obstructed,  then 
proceed  slowly,  oscillate  for  a  while,  until  at  length,  getting 
beyond  the  diseased  parts,  it  has  again  darted  off  with  the  same 
velocity  as  it  came.  Again,  it  may  frequently  be  observed, 
when  a  vessel  is  so  full  of  coloured  corpuscles  that  they  can 
no  longer  be  distinguished,  and  seem  to  have  melted  together, 
that,  on  rupturing  it,  these  bodies,  when  extravasated,  at  once 
assume  their  original  form,  and  arrange  themselves  just  the 
same  as  they  do  coming  from  a  healthy  structure.  I  cannot 
suppose,  therefore,  that  the  cause  of  stasis  is  connected  with 
adhesiveness  of  the  blood  corpuscles;  indeed,  many  of  the 
valuable  observations  of  Mr.  Lister  himself  only  confirm  what 
I  have  long  maintained,  namely,  that  they  simply  are  drawn 
together  and  brought  more  closely  into  contact  by  some  external 
force,  which  is  excited  by  irritation  of  the  surrounding  tissue." 

Later  experiments  have  to  some  extent  confirmed  the  con- 
clusions of  Bennett.  Dr.  A.  Eyneck  has  made  some  experiments 
in  the  Physiological  Laboratory  at  Gratz,  upon  the  production 
of  stasis,  and  has  shown  that  all  its  phenomena  can  be  produced 
by  irritation  in  the  webs  of  frogs,  in  which  milk  or  defibrinated 
blood  of  mammalia  has  been  substituted  for  the  circulating 
fluid.  If  a  web  so  treated  be  touched  with  a  rod  moistened 
with  ammonia,  the  phenomena  of  stasis  occur  in  the  irritated 
part;  the  capillaries  become  crowded  with  milk  globules,  ex- 
hibiting the  appearance  of  grey  cords.  When  defibrinated  blood 
is  used,  the  results  are  even  more  striking,  for  in  this  case  the 
choked  vessels  soon  exhibit  in  every  respect  the  same  appear-, 
ance  as  in  ordinary  inflammation. 

These  results  seem  to  make  it  perfectly  clear  that  the  local 
changes  which  lead  to  the  production  of  stasis  must  have  their 
seat  either  in  the  walls  of  the  vessels,  or  in  the  tissues  which 
immediately  surround  them.  To  determine  this  more  precisely, 
Dr.  Eyneck  varied  this  experiment  by  filling  the  vessels  with 
an  indifferent  liquid,  such  as  a  solution  of  common  salt  of 
proper  strength,  so  as  to  remove  the  blood ;  then  subjecting  their 


PHENOMENA.  11 

internal  surface  for  a  few  moments  to  an  agent,  which,  by  virtue 
of  its  chemical  action,  might  be  expected  to  modify  or  destroy 
its  vitality,  such  as  solution  of  chromic  acid,  chloride  of  gold,  or 
sulphate  of  copper.  The  results  were  decisive :  no  stasis  was 
produced  by  irritation  in  webs  which  had  been  thus  treated. 

It  has  been  observed  that  there  is  an  apparent  increase  of  the 
white  corpuscles  in  the  inflamed  part,  and  a  remarkable  disposi- 
tion in  them  to  adhere  to  the  walls  of  the  vessel;  but  as  no 
pores  are  visible  in  the  capillaries  under  the  highest  magnifying 
powers,  the  fact  that  the  white  corpuscles  passed  through  the 
vessels  into  the  tissues,  which  was  pointed  out  by  Dr.  Addison, 
and  which  has  now  been  proved,  could  not  be  accepted ;  but  in 
1846  the  statements  of  Dr.  Addison  were  confirmed  by  Dr. 
Augustus  Waller,  who  says  {Philosophical  Magazine,  vol.  xxix., 
p.  397,  1846),  "  In  some  instances  the  manner  in  which  the  cor- 
puscle escaped  from  the  interior  of  the  tube  could  be  distinctly 
followed ;  that  part  of  the  tube  in  contact  with  the  external  side 
of  the  corpuscle  gradually  disappeared,  and  at  nearly  the  same 
time  might  be  seen  the  formation  of  a  distinct  line  of  demarca- 
tion between  the  inner  segment  of  the  corpuscle  and  the  fluid 
parts  of  the  blood  in  contact  with  it.  Any  slight  agitation  then 
was  capable  of  disengaging  the  corpuscle  from  the  vessel  to 
which  it  was  now  external."  The  escape  of  the  corpuscle  was 
supposed  by  Dr.  Waller  to  be  due  to  an  exudate  being  given 
off  from  the  corpuscle  possessing  some  solvent  power  over  the 
vessel,  or  that  the  solution  of  the  vessel  took  place  in  virtue  of 
some  of  those  molecular  actions  which  arise  from  the  contact  of 
two  bodies ;  actions  which  are  known  as  exerting  such  extensive 
influence  in  digestion,  and  referable  to  what  is  termed  the 
catalytic  power.  But  it  is  now  proved  that  the  capillaries 
consist  of  protoplasm,  hence  the  penetration  of  their  contractile 
walls  by  the  amoeboid  corpuscles,  and  the  subsequent  closure 
of  the  openings  when  the  passage  is  completed,  can  be  readily 
understood. 

In  order  to  do  this  it  must  be  further  borne  in  mind,  as 
pointed  out  by  Prof.  Cohnheim,  that  a  white  corpuscle — leuco- 
cyte, sarcophyte — is  not  a  cell  in  the  sense  in  which  the  term 
was  formerly  used,  but  is  a  mass  of  contractile  material  en- 
dowed with  the  faculty  of  movement.  This  movement,  from 
its  similarity  to  that  possessed  by  the  amoebse,  has  been  termed 


]  2  INFLAMMATION. 

amceboid,  and  is  as  follows : — The  mass  constantly  changes  its 
form.  But  as  this  goes  on  in  all  parts  of  the  hyaline  substance, 
of  which  it  consists,  simultaneously,  the  only  way  in  which  it 
can  be  understood  is  by  confining  the  attention  to  one  point 
at  a  time ;  it  will  then  be  seen  that  each  act  of  movement  begins 
by  the  budding  of  a  ray,  or  process  of  contractile  substance  in 
a  centrifugal  direction.  What  next  happens  varies  in  different 
cases.  Sometimes  the  projection  subsides  just  in  the  same  way 
as  it  was  formed;  at  others,  the  finely  granular  fluid,  which 
occupies  the  more  central  parts  of  the  corpuscle,  streams  into 
the  offshoot,  gradually  widening  it  out  until  it  grows  into  a  mass 
greater  than  the  remainder,  which  it  finally  draws  into  itself. 
It  is  evident  that  the  process  last  described  must  always  be  at- 
tended with  locomotion,  for  each  time  it  is  repeated  the  whole 
mass  rallies  round  a  new  centre,  the  position  of  which  cor- 
responds to  the  extremity  of  the  offshoot. 

As  already  stated,  these  white  corpuscles  accumulate  in  large 
numbers  in  the  vessels  of  the  inflamed  part  in  close  contact  with 
the  walls.  They  then  sink  into  the  substance  of  the  walls,  and 
pass  through  them  into  the  surrounding  tissue.  During  this 
process  it  is  seen  that  the  corpuscle  pierces  the  walls  of  the 
vessels  by  means  of  prongs  of  a  delicate  homogeneous  material, 
similar  at  first  to  a  shining  thread.  Some  of  these  prongs  pro- 
ject, and  as  a  prong  increases  in  length  it  thickens  at  its  base ; 
the  substance  of  the  corpuscle  now  tends  towards  it,  becoming 
smaller  as  the  prong  gets  larger ;  in  fact,  the  contents  of  the 
corpuscle  are  drawn  into  the  substance  of  the  prong,  which  be- 
comes rounded  otf  at  its  tip,  and  finally  assumes  the  contour  of 
the  corpuscle.  Having  escaped  from  the  vessels  into  the  sur- 
rounding tissue,  the  corpuscles  continue  their  active  movements, 
and  increase  rapidly  in  number. 

Yirchow  describes  two  forms  of  inflammation,  namely — (1st.) 
The  jparenchymatous  inflammation,  w4iere  the  process  runs  its 
course  in  the  interior  of  tlie  tissue  elements  (e.g.,  connective 
tissue  cells,  or  germ  masses,  hepatic  and  cartilage  cells),  with- 
out one  being  able  to  detect  the  presence  of  any  free  fluid  which 
has  escaped  from  the  blood ;  and  {2d)  The  secretory  (exudative) 
inflammation  of  superficial  tissue  elements,  where  an  increased 
escape  of  fiuid  takes  place  from  the  blood,  and  conveys  the  new 
products  of  growth  and  altered  secretion  with  it  to  the  surface. 


PHENOMENA. 


13 


Virchow  is  also  of  opinion  that  there  is  no  inflammatory  exuda- 
tion at  all,  in  the  sense  in.  which  it  has  usually  been  assumed  to 
exist,  but  that  the  exudation  is  essentially  composed  of  the 
material  which  has  been  generated  in  the  inflamed  tissue  itself, 
through  the  change  in  its  condition,  and  of  the  transuded  fluid 
derived  from  the  vessels.  If  a  part  possesses  a  great  number  of 
vessels,  particularly  if  they  are  superficial,  it  will  be  able  to 
furnish  an  exudation.  If  this  is  not  the  case,  there  will  be  no 
exudation,  but  the  whole  process  will  be  limited  to  the  occur- 
rence in  the  real  substance  of  the  tissue  of  the  special  changes 
which  have  been  induced  by  the  inflammatory  stimulus ;  and 
he  concludes  by  stating  that  every  parenchymatous  inflamma- 
tion has,  from  its  outset,  a  tendency  to  alter  the  histological 
and  functional  character  of  an  organ.  Every  inflammation  witli 
free  exudation  in  general  affords  a  certain  degree  of  relief  to  the 
part ;  it  conveys  away  from  it  a  great  mass  of  the  noxious  matters 
with  which  it  is  clogged,  and  the  part  therefore  appears  com- 
paratively to  suffer  much  less  than  that  which  is  the  seat  of  a 
parenchymatous  disease. 

Of  the  former  (the  parenchymatous)  he  gives  an  example  in 


Fig.  3.  — Parenchymatous  Keratitis.  At  A  the  cornea  corpuscles  are  seen  iu  a 
nearly  normal  condition,  at  B  enlarged,  at  C  and  D  still  more  enlarged,  and  at 
the  same  time  clouded.     350  diameters. — (Virchow.) 

inflammation  of  the  cornea ;  and  of  the  latter  form  of  inflam- 
mation we  have  an  example  as  it  occurs  in  mucous  membranes, 


14  INFLAMMATION. 

where  generally  no  fibrine  is  formed,  but  mucus,  wliicb  does 
not  exist  in  the  blood.  An  inflamed  mucous  membrane  pro- 
duces large  masses  of  epithelium  in  a  short  time;  they  are 
merely  products  of  the  membrane,  which  is  not  infiltrated  with 
epithelium  or  mucus  coming  from  the  blood,  but  the  peculiar 
product  of  the  membrane,  and  is  conveyed  to  the  surface  by 
means  of  the  fluid  transuding  from  the  blood.  In  the  same 
manner,  fibrine,  instead  of  being  a  real  exudate  from  the 
vessels,  is  a  local  product  of  the  tissues  on  and  in  which  it 
is  found,  and  is  conveyed  to  the  surface,  as  in  pleuritis,  in  the 
same  way  as  the  mucus  of  the  mucous  membrane.  We  can 
thus  explain  that  the  fibrinous  condition  of  the  blood  observed 
in  inflammations  is  a  result  of  the  absorption  of  the  increased 
quantity  of  fibrine  produced  by  the  local  metamorphosis  of 
transuded  serum. 

We  may  conclude  that  the  effect  of  inflammation  on  all  living 
tissues  is  a  modification  of  the  action  of  individual  cells,  result- 
ing from  some  alteration  in  the  properties  of  the  walls  of  the 
capillaries  nearest  to  the  seat  of  irritation  or  injury.  Most  of 
these  modifications  are  accompanied  by  transudation  of  liquor 
sanguinis — exudative  inflammations ;  whilst  in  others,  and  these 
are  the  most  destructive,  the  process  is  limited  to  textural 
changes  in  the  substance  of  the  part — parenchymatous  inflam- 
mation. The  latter  may,  however,  in  some  instances  be 
changed  into  the  former,  by  increasing  the  stimulus,  or  by 
elevating  the  vitality  of  the  part ;  for,  as  already  observed, 
the  first  change  noticeable  in  a  non-vascular  structure  when 
irritated  is  similar  to  that  seen  in  the  same  structure  when 
removed  from  the  influences  of  vital  action,  i.e.,  excised,  and  that 
those  processes,  peculiar  to  the  inflammatory  state,  are  the  natural 
changes  occurring  in  an  injured  living  structure.  Now,  if  the 
living  structure  be  much  debilitated  by  any  cause  previous  to 
the  occurrence  of  the  irritation,  the  natural  response  will  be 
feeble,  delayed,  or  the  part  may  even  die  without  presenting  any 
signs  of  exudative  reaction. 


CAUSES  OF  INFLAMMATION. 

It  will  be  sufficient  here  merely  to  notice  the  remote  causes 
of  inflammation.      These   may   be   divided   into  predisposing 


CAUSES  OF  INFLAMMATION.  15 

and  exciting  causes  : — 1st.  Predisposing  causes  are  influences 
not  of  themselves  essentially  irritant,  yet  often  co-operate  with 
others  in  inducing  the  inflammatoiy  process.  They  may  be 
summarised  as  follows — debility  either  of  an  organ  or  of  the 
whole  body  arising  from  old  age ;  previous  disease  or  a  natural 
weakness ;  hereditary  taint  or  predisposition ;  obstruction  of 
the  blood-vessels ;  plethora ;  climatic  influences  ;  dietetic  errors ; 
insufficient  ventilation,  and  ill-treatment  of  all  kinds. 

2d.  Exciting  or  determining  Causes. — These  are  agents  which, 
if  powerful,  will  of  themselves  be  sufficient  to  determine 
the  inflammatory  process  even  in  healthy  tissues,  but  which 
will  do  so  with  more  certainty  in  parts  predisposed.  They 
may  be  arranged  as  follows  : — Direct  violence ;  the  appli- 
cation of  irritants ;  exposure  to  heat  and  cold ;  the  presence  of 
foreign  bodies,  or  of  parts  deprived  of  life  ;  retained  concretions 
or  excretions;  abnormal  conditions  of  the  blood,  as  in  rheumatism 
and  anaemia,  or  when  containing  some  irritating  ingredient,  mor- 
bid or  specific  virus,  or  poisonous  drug.  I  think  Dr.  Burdon 
Sanderson  simplifies  the  causes  and  origin  of  inflammation  very 
much.  He  says — "  With  reference  to  their  origin,  all  inflam- 
mations may  be  comprised  in  two  classes — extrinsic  and  in- 
trinsic. Of  these  two  terms,  the  former  is  applicable  to  all  those 
cases  in  which  an  injury,  either  sustained  by  the  affected  part 
or  inflicted  elsewhere,  is  the  obvious  cause  of  the  morbid  process ; 
the  latter  to  those  inflammations  which,  from  the  concealment 
of  their  cause,  are  commonly  called  idiopathic.  If,  however,  we 
desire  to  speak  accurately,  we  must  discard  this  word  altogether ; 
for  there  is  no  case  in  which  it  can  be  reasonably  doubted  that 
an  injury  must  have  preceded  the  earliest  sign  of  local  disorder, 
however  little  we  may  know  either  of  the  nature  of  the  agent 
or  of  the  mode  of  its  action.  We  might  advantageously  sub- 
stitute for  idiopathic  either  of  the  words  intrinsic  or  secondary ; 
but  inasmuch  as  there  is  no  channel  by  which  an  agent  from 
within,  i.e.,  from  some  other  part  of  the  body,  could  penetrate 
into  a  tissue,  excepting  by  the  blood-vessels  or  lymphatics,  we 
are  entitled  to  use  the  only  word  which  fully  expresses  this 
view  of  the  mode  of  introduction  of  the  material  cause,  and  to 
designate  all  so-called  idiopathic  inflammations  infective. 

"  From  what  has  been  said  it  may  be  readily  understood  that 
the  primary  inflammations  naturally  affect  those  parts  princi- 


16  INFLAMMATION. 

pally  which  are  exposed  to  external  influences,  while  those  of 
the  other  class  occur  by  preference  in  parts  and  organs  to  which 
there  is  no  access  excepting  through  the  circulation.  These 
distinctions,  however,  are  not  constant,  for  there  are  many  in- 
stances in  which  secondary  inflammations  affect  external  parts, 
and  many  others  in  which  internal  organs  are  the  seat  of 
primary  inflammations,  as,  for  example,  when  nepliritis  arises 
from  exposure  to  cold.  Much  more  important  distinctions, 
however,  may  be  based  on  a  comparison  of  the  structural 
changes  which  the  two  processes  determine  in  the  tissues 
affected ;  or,  in  other  words,  on  their  pathological  anatomy.  In 
making  this  comparison,  there  is  one  important  principle  to  be 
borne  in  mind  :  In  all  injlammations,  the  form  of  the  lesion  is 
dependent  on  that  of  the  area  of  influence  of  the  injury.  Thus, 
in  those  cases  of  primary  inflammation  in  which  it  may  be 
supposed  that  an  impression  received  by  afferent  nerves  distri- 
buted to  mucous  or  cutaneous  surfaces,  is  reflected  to  internal 
organs  (as  in  the  case  of  nephritis  from  cold,  already  referred  to), 
the  area  of  influence  of  the  injury  is  wide  enough  to  comprise 
whole  organs,  and  the  resulting  lesions  are  of  corresponding 
extent.  In  the  strictly  local  inflammations,  the  correspondence 
in  form  between  cause  and  effect  is,  of  course,  closer  and  more 
obvious,  the  area  of. a  traumatic  inflammation  being  larger  than 
that  of  the  injury  which  produces  it,  but  of  exactly  similar  form. 
As  regards  infective  inflammations,  the  correspondence  is  not  so 
plain,  but  the  consideration  of  their  pathological  anatomy  is 
sufficient  to  satisfy  us  that  it  is  equally  complete.  It  is  the 
anatomical  character  of  all  infective  inflammations  that  the 
lesions  to  which  they  give  rise  are  disseminated  rather  than 
diffused.  Particles  of  matter,  of  the  nature  of  which  we  can 
assert  nothing,  excepting  that  they  are  of  extreme  minuteness,  are 
conveyed  from  a  primarily  inflamed  part  to  other  parts  previously 
healthy,  and  become  foci  of  infective  induration  or  suppuration 
(miliary  tubercles,  pysemic  abscesses),  each  of  w^hich  is  the  pro- 
duct— if  one  may  be  allowed  the  expression — of  a  single  seed." 


VAlilETIES  OF  INFLAMiMATION  DUE  TO  CAUSATION. 

And   to   quote   from   the    same   author   on   this   subject : — 
"  Although  if  we  be  careful  to  distinguish  what  is  essential  to 


VARIETIES  OF  INFLAMMATION  DUE  TO  CAUSATION.  17 

the  process  of  inflammation,  viz.,  the  altered  state  of  the  vessels, 
from  the  phenomena  which  accompany  it,  and  the  textural 
germination  which  it  produces,  its  characters  will  appear  to  ns 
to  present  very  slight  variation,  yet  the  visible  results  by  which 
it  manifests  itself  differ  widely  in  different  cases.  It  is  there- 
fore necessary,  in  order  to  complete  the  present  subject,  to  con- 
sider in  what  degree  these  differences  correspond  to  differences 
in  the  causes  which  produce  them. 

"  Vesication. — If  a  hot  iron  is  applied  to  the  skin  at  a  sufficient 
temperature,  it  at  once  destroys  its  vitality.  If  the  temperature 
be  a  little  below  that  w^hich  is  necessary  to  produce  this  result, 
the  blood  contained  in  the  vessels  coagulates,  and  the  tissue 
eventually  dies.  At  a  still  lower  temperature  the  skin  retains 
its  vitality,  but  blisters  are  formed  at  or  around  the  injured  part. 

"  If  the  mesentery  of  a  guinea-pig  is  touched  with  a  heated 
surface,  and  the  effect  observed  under  the  microscope,  it  is  found 
that  stasis  is  produced  which  is  co-extensive  with  the  surface  of 
contact.  It  is  tolerably  certain  that  in  like  manner,  in  vesica- 
tion of  the  skin  by  heat,  the  circulation  of  the  heated  part  is 
abruptly  brought  to  a  standstill.  As,  outside  of  the  area  of 
stagnation,  it  goes  on  at  first  with  unabated  then  with  increased 
vigour,  while  the  walls  of  the  capillaries  are  probably  acted 
upon  by  the  heat  in  such  a  manner  as  to  render  them  more 
permeable,  we  can  readily  understand  how  it  happens  that 
liquor  sanguinis  is  exuded  more  rapidly  and  more  abundantly 
than  in  ordinary  inflammations.  From  the  researches  of  Dr. 
Samuel  of  Konigsberg  it  seems  probable  that  the  effects  of 
liquid  vesicants  agree  with  those  of  heat  in  all  the  respects 
which  have  been  referred  to ;  so  that  the  peculiarity  of  the 
mode  of  action  of  vesicant  agents  in  general,  would  seem  to  lie 
in  its  suddenness,  and  in  the  faculty  which  they  possess  of  at 
once  producing  those  changes  in  the  capillary  wall  which  in  ordi- 
nary inflammation  require  a  longer  time  and  a  more  gradual 
process  for  their  production.  In  this  way  the  exudation  of 
liquor  sanguinis,  instead  of  being  deferred  until  the  slowing 
of  the  circulation  has  commenced,  begins  immediately,  and, 
favoured  by  the  primary  arterial  afflux,  and  the  increased  intra- 
vascular pressure  consequent  on  the  sudden  capillary  obstruc- 
tion, is  so  abundant  that  the  liquid  collects  in  blisters. 

"  Relation  between  inflammation  and  the  reparaJAve  process. — 

c 


18  INFLAMMATION. 

•When  the  local  injury  is  so  intense  as  to  destroy  the  vitality  of 
the  affected  part  at  once,  that  part  becomes  surrounded  with  a 
zone  of  inflamed  tissue,  from  which  it  eventually  separates,  leav- 
ing behind  it  a  granulating  surface.  To  understand  this  process 
of  demarcation  and  separation,  it  is  in  the  first  place  to  be  borne 
in  mind  that  the  exuded  liquid  contains  the  fibrine-producing 
elements  of  the  blood,  and  that  contact  with  dead  substance  at 
once  determines  coagulation  of  all  such  fibrinogenous  liquids. 
Accordingly,  the  first  step  in  the  process  of  reparative  separation 
is  the  formation,  in  contact  with  the  dead  part,  of  a  more  or  less 
solid  stratum  of  fibrine,  in  which  stratum  the  production  of  new 
capillaries  and  granulation  tissue  commences." 


LOCAL  SYMPTOMS  OF  INFLAMMATION. 

Bedness. — In  the  lower  animals  this  symptom  can  only  be  seen 
in  the  white  parts  of  the  body,  such  as  the  white  skin  of  the 
heels  of  some  horses,  and  upon  the  visible  mucous  membranes. 
It  arises  from  an  increased  quantity  of  blood  in  the  part,  both 
in  the  capillaries  and  in  the  large  vessels ;  and  when  the  con- 
gestion is  excessive,  particularly  if  it  be  due  to  some  mechanical 
cause  or  obstruction,  the  redness  is  increased  by  the  passage  of 
the  red  corpuscles  through  the  walls  of  the  capillaries  without 
rupture.  The  corpuscles,  in  passing  through  the  vessel,  become 
constricted  in  their  centre,  so  as  to  assume  an  hour-glass  shape. 
This  passage  of  the  red  corpuscles  can  be  seen  in  the  frog's  web 
after  ligature  of  the  femoral  vein.  In  some  cases  the  redness 
may  be  caused  by  extravasation  of  blood,  but  generally  it  de- 
pends on  engorgement.  The  redness  of  inflammation  is  more  or 
less  vivid ;  deepest  in  the  centre,  gradually  shading  off  towards 
the  edges  of  the  inflamed  part,  and  partly  removable  by  pres- 
sure ;  but  if  extravasation  be  present,  its  margin  will  be  more 
defined,  and  the  colour  is  not  removable  by  pressure. 

The  aspect  of  the  redness  may  differ  according  to  various 
circumstances ;  if  the  capillary  networks  of  the  part  be  uniformly 
distended,  the  injection  will  appear  as  an  uniform  deep  blush ; 
if,  on  the  other  hand,  they  are  moulded  in  the  form  of  villi  or 
folds  of  mucous  membrane,  the  surface  will  have  the  appearance 
of  a  pile  of  red  velvet.  In  fibrous  structures  the  redness  has 
a  streaky  appearance.     The  redness  does  not  depend  upon  the 


LOCAL  SYMPTOMS.  19 

formation  of  new  blood-vessels,  a  process  which  does  not  take 
place  till  the  inflammation  is  much  advanced.  Staining  of  the 
tissues  with  transuded  hsematine  may  occur  soon  after  stasis 
has  been  established. 

The  veterinary  practitioner  should  always  carefully  distinguish 
between  genuine  inflammatory  redness  and  that  which  closely 
resembles  it  in  the  dead  body,  namely,  hypostatic  redness,  which 
depends  on  mechanical  causes  or  the  mode  in  which  death  has 
been  produced. 

Eedness  existing  only  in  a  depending  part  of  the  body,  such 
as  the  side  upon  which  an  animal  has  lain  since  its  death,  with- 
out thickening  of  the  part,  must  never  be  looked  upon  as 
evidence  of  the  inflammatory  condition. 

The  presence  or  absence  of  redness  is  not  of  itself  a  proof  of 
the  presence  or  absence  of  inflammation.  Eedness  exists  with- 
out inflammation :  thus  we  find  the  visible  mucous  membranes 
red  and  injected  in  many  diseases,  but  no  one  for  a  moment 
supposes  that  these  membranes  are  inflamed.  On  the  other 
hand,  absence  of  redness  is  no  proof  that  inflammation  does  not 
exist,  for  some  inflammations,  as  those  of  the  cornea,  of  the 
arachnoid  membrane,  and  of  articular  cartilage,  are  attended 
with  no  redness,  but  rather  with  opacity,  and  it  is  only  in  con- 
junction with  other  indications  that  redness  can  be  regarded  as 
a  symptom  of  inflammation. 

Pain. — The  pain  of  inflammation  varies  much  in  degree  and  in 
kind,  according  to  its  cause,  intensity,  and  seat.  The  pain  of 
laminitis,  of  punctured  foot,  of  open  joint,  or  of  inflammation 
of  any  unyielding  fibrous  or  bony  texture,  amounts  very  often  to 
extreme  agony.  The  pain  of  inflamed  serous  membrane,  more 
especially  of  inflamed  pleura,  is  of  a  sharp,  darting  kind,  giving  rise 
to  colicky  symptoms.  In  traumatic  peritonitis,  on  the  contrary, 
although  the  pain  may  be  excessive,  the  animal  does  not  always 
exhibit  it,  owing  to  the  prostration  which  is  present.  The  pain  of 
inflamed  mucous  membrane  is  dull,  or  simply  an  uneasiness  not 
amounting  to  actual  pain.  But  pain  is  not  a  constant  symptom 
of  inflammation,  and  of  inflammation  without  it  the  following 
may  be  enumerated  : — Insidious  and  indolent  forms  of  scrofulous 
inflammation,  especially  in  horned  cattle,  in  which  extensive 
disorganizations  are  often  produced  without  the  animal  ever 
having  manifested  any  signs  of  pain;  inflammation  of  a  para- 


20 


INFLAMMATION. 


lyzed  part,  with  sloughing,  as  in  the  posterior  extremities,  after 
parturient  apoplexy ;  or  that  inflammation  occurring  in  the 
foot,  pastern,  and  fetlock  of  the  horse,  after  neurotomy  has  been 
performed ;  typhoid  inflammation  of  the  lungs,  where  little  indi- 


FiG.  4  shows  the  immensely  enlarged  condition  of  the  coronet  and  pastern,  from 
inflammation  and  gelatinous  degeneration,  succeeding  neurotomy,  a,  Toe  of  foot ; 
h,  Fetlock  pad. 

cation  has  been  shown  during  life,  and  it  must  also  be  presumed 
that  the  formation  of  pulmonary  abscesses  in  glanders  is  un- 
attended by  pain.  We  therefore  conclude  that  the  absence  of 
pain  is  no  indication  of  the  absence  of  inflammation,  and  that 
the  presence  of  pain  is  not  impossible  without  inflammation. 
Of  this  we  have  many  examples,  as  in  spasmodic  colic,  where 
pain  is  intense ;  in  tetanus,  and  in  cramp  of  the  vohmtary 
muscles.  One  peculiar  case  came  under  my  immediate  know- 
ledge, where  pain  was  present  to  a  most  exquisite  degree,  with- 
out either  spasm  or  inflammation,  and  where  the  external  iliac 
artery  of  the  near  (left)  side  was  plugged  by  a  fibrinous  clot 
(embolus).  The  animal  while  at  rest  exhibited  nothing  unusual, 
but  if  put  to  work  in  the  carriage  he  would  not  proceed 
500  yards  without   the   limb   becoming   icy   cold;    he   would 


LOCAL  SYMPTOMS.  21 

then  groan,  break  out  in  sweats  upon  various  parts  of  the 
skin,  would  attempt  to  lie  down ;  indeed,  when  taken  to  his 
stable,  he  would  lie  down,  roll,  and  paw,  as  if  suffering  from 
spasmodic  colic.  This  occurred  again  and  again  ;  and  upon  the 
animal  being  killed,  the  condition  of  the  artery  was  discovered. 

The  sudden  cessation  of  pain  in  violent  inflammation  is  much 
to  be  dreaded,  as  it  gives  the  practitioner  good  reason  to  suspect 
that  the  vitality  of  the  part  has  been  lost,  from  the  inflammation 
having  gone  on  to  gangrene. 

The  situation  of  pain  is  not  always  the  seat  of  the  inflam- 
matory action,  as  in  inflammation  of  the  liver  the  pain  is 
sometimes  in  the  off  (right)  shoulder,  as  exhibited  by  distinct 
shoulder  lameness.  This  is  termed  sympathetic  pain,  and  is 
the  only  example  within  my  knowledge  where  this  sympa- 
thetic or  reflected  pain  can  be  demonstrated,  although  the  prac- 
titioner may  surmise  that  this  occurs  in  inflammation  of  other 
organs.     In  periodic  ophthalmia  it  may  be  seen  to  some  extent. 

The  Cause  of  Pain. — This  has  been  ascribed  to  compression 
of  the  nerves  of  the  part  by  congestion  of  the  vessels  and 
effusion  ;  an  exaltation  of  nervous  function ;  a  painful  stretch-, 
ing  of  the  nerves,  arising  from  distension  of  their  small  nutri- 
tious vessels ;  or  to  impression  produced  on  the  nervi  vasorum 
by  the  slight  dilatation  and  elongation  of  the  arteries  during 
each  impulse  of  the  blood. 

In  general,  the  intensity  of  the  pain  depends  upon  the 
firmness  and  inelasticity  of  the  part  affected.  Thus  the  pain 
of  laminitis  is  of  a  most  excruciating  character,  from  th& 
inflamed  tissues  being  confined  within  the  horny  foot.  The 
pain  of  open  joint  is  also  of  this  nature,  from  the  firmness  and 
hardness  of  the  tissues  involved;  namely,  bone,  ligaments, 
synovial  membrane,  &c.  Such  structures  as  these,  along  with 
tendons  and  faschiae,  possessing  little  sensibility  during  health, 
in  disease  become  extremely  sensitive,  and  the  pain  in  them 
is  often  of  an  agonizing  character.  Dr.  Lionel  Beale  has 
demonstrated  that  in  textures  which  in  health  exhibit  but 
slight  sensitiveness,  and  become  eminently  so  when  inflamed, 
there  is  a  very  great  increase  in  the  germinal  matter  which 
they  contain,  and  that  this  often  proceeds  to  such  an  extent 
during  inflammation  that  the  ramifications  of  the  nerves  appear 
as   lines   of  masses   of  germinal   matter ;   so   that  in  tissues 


22  INFLAMMATION. 

which  thus  become  highly  sensitive  during  inflammation  the 
feeling  of  pain  must  be  due  to  the  increase  of  germinal  matter 
of  the  nerves,  as  well  as  that  of  other  tissues.  Muscular 
and  other  softer  structures,  though  endowed  with  much  sensi- 
tiveness during  health,  are  not  nearly  so  painful  in  inflamma- 
tion. This  arises  from  their  yielding  nature,  giving  way  and 
allowing  free  swelling  of  the  part,  which  in  most  cases  seems 
to  relieve  pain.  The  veterinarian  has  a  good  example  of  this 
in  lymphangitis,  the  pain  and  lameness  of  which  seem  to  sub- 
side as  the  swelling  of  the  parts  appears.  In  the  treatment 
this  should  be  borne  in  mind,  as  remedies  that  promote  swell- 
ing (hot  fomentations)  afford  very  marked  relief. 

Swelling. — The  swelling  of  inflammation  depends  upon — 1st. 
The  congestion  of  the  vessels ;  and  2d.  The  exudation  of  liquor 
sanguinis  into  the  tissues. 

Swelling  of  an  external  inflamed  part  may  be  looked  upon — 
except  in  the  case  of  the  articulations,  where  it  is,  when  very 
great,  indicative  of  ulceration — as  a  favourable  sign,  its  occur- 
rence often  affording  relief.  But  when  it  occurs  in  the  organs 
essential  to  life,  such  as  the  parenchyma  of  the  lungs,  or  upon 
the  glottis,  its  presence  may  soon  put  an  end  to  the  life  of  the 
animal.  Swelling  is  not  always  an  indication  of  inflammatory 
action ;  the  swellings  of  dropsy,  anasarca,  and  of  purpura  and 
scarlatina,  are  very  different  from  those  of  inflammation.  The 
swelling  of  purpura  is  very  characteristic,  terminating  abruptly, 
superiorly,  as  if  a  cord  had  been  drawn  around  the  limb; 
the  swelling  of  anasarca  will  be  found  to  be  most  bulky  at 
its  most  depending  part.  Tumours  are  also  examples  of  swell- 
ing without  inflammation ;  cartilage,  which  is  non-vascular, 
swells  by  its  cells  taking  up  more  matter,  and  assuming  the 
form  of  large  round  corpuscles.  In  proportion  as  they  take 
up  this  matter,  they  enlarge  in  all  directions,  often  forming 
spots  or  protuberances  on  the  surface  of  the  articulation,  as  may 
be  seen  in  navicular  lameness. 

Heat. — The  temperature  of  the  inflamed  part  seems  to  be  con- 
siderably increased,  affecting  the  sensations  of  the  observer  as 
well  as  of  the  sufferer ;  hence  the  name  "  inflammatio,"  a  burn- 
ing. But  this  increase  of  heat  is  not  so  decided  as  one  would 
imagine,  and  the  experiments  of  Hunter  go  to  prove  that  the 
difference,  in  most  cases,  is  not  more  than  one  degree;   and, 


LOCAL  SYMPTOMS.  23 

according  to  some  observers,  it  seems  doubtful  whether  the 
heat  of  the  inflamed  part  is  even  higher  than  that  of  the  other 
parts  of  the  body.  The  greatest  rise  in  the  temperature  is  found 
where  the  inflamed  part  is  far  removed  from  the  centre  of  cir- 
culation, and  where  the  natural  temperature  is  several  degrees 
below  that  of  the  blood  at  the  heart,  as  in  the  feet  of  our 
patients;  and  it  is  also  found  that  in  parts  remote  from  the 
centre  of  circulation  the  heat  is  most  distressing. 

The  sense  of  heat  which  the  patient  experiences  must  be  partly 
due  to  the  increased  sensibility  of  the  inflamed  part,  and  also  to 
the  fact  that  the  functions  of  the  sensory  nerves  are  increased 
and  perverted.  The  greatest  degree  of  heat  has  been  found  to 
exist  in  rinderpest,  and  this  was  not  due  to  any  inflammation 
of  the  part,  but  to  the  rapidity  of  the  textural  changes  that 
took  place  in  that  plague.  In  this  disease  the  highest  record 
made  by  me  was  109°.  The  highest  temperature  recorded  by 
writers  on  human  medicine  is  11  Of®;  this  was  in  tetanus,  which 
is  not  an  inflammatory  disease. 

Some  late  experiments  upon  the  production  of  increased  heat 
in  a  part  inflamed  may  be  interesting  to  the  reader. 

The  experiments  of  Mr.  Simon,  corroborated  by  those  of  M. 
0.  Weber,  go  to  prove  that  inflammation  does  actually  cause 
a  local  production  of  heat,  for  the  application  of  a  thermo- 
electric needle  showed  (1st.)  that  the  blood  passing  to  an  in- 
flamed part  is  less  warm  than  that  part  itself;  {2d.)  that  th6 
venous  blood  returning  from  an  inflamed  part  is  warmer  than 
the  arterial  blood  supplying  it,  though  less  warm  than  the  focus 
of  inflammation;  and  (3d.)  that  the  venous  blood  returning 
from  an  inflamed  limb  is  warmer  than  the  corresponding  current 
on  the  opposite  side  of  the  body. 

The  subject  has  been  taken  up  by  MM.  Jacobson  and  Bern- 
hardt; and  the  results  of  their  investigations  are  opposed  to  the 
above,  and  corroborative  of  those  of  Hunter.  They  excited  pleurisy 
of  one  side,  or  general  inflammation  of  the  peritoneal  cavity  in 
rabbits,  by  injecting  dilute  acetic  acid  or  caustic  ammonia ;  and 
when  inflammation  was  established,  they  compared  the  tem- 
perature of  the  inflamed  serous  sacs  with  that  of  others,  or 
with  the  blood  in  the  right  or  left  ventricles  of  the  heart.  In 
a  preliminary  set  of  experimsnts  they  discovered  that  great 
exactness  was    obtainable  in  ascertaining  the  temperature  of 


24  INFLA.MMATION. 

internal  parts  by  the  insertion  of  the  thermo-electric  needle, 
and  that,  as  a  general  rule,  the  pleural  cavities  were  from  about 
one-tenth  to  one-fifth  of  a  degree  per  cent,  cooler  than  the  peri- 
toneal cavity,  and  from  one-fifth  to  one-half  of  a  degree  cooler 
than  the  left  side  of  the  heart.  It  was,  therefore,  clear  that, 
if  a  temperature  of  more  than  one-half  a  degree  per  cent,  was 
present  after  inflammation  had  been  set  up,  it  could  not  be 
due  to  the  blood  current,  but  must  have  arisen  from  some 
local  and  independent  source  of  heat.  But  the  results  of 
experiments  showed  that,  so  far  from  any  augmentation,  there 
was  a  distinct  depression  of  temperature  on  the  inflamed  side, 
amounting  in  one  case,  when  the  pleural  sac  was  filled  with 
fibrinous  fluid,  to  as  much  as  one-half  of  a  degree  per  cent,  less 
than  that  of  the  peritoneum,  and  about  one-third  of  a  degree 
below  that  of  the  opposite  pleura,  and  more  than  one-half  of  a 
degree  cooler  than  that  of  the  left  heart.  Again,  in  peritonitis 
the  temperature  was  less  than  that  of  the  left  heart  by  as 
much  as  two-thirds  of  a  degree  per  cent.,  and  in  one  case  it 
was  1-1°  per  cent,  (equal  to  2°  Fahr.)  below  that  of  the  blood 
in  the  left  ventricle. 

To  settle  this  uncertainty,  experiments  have  been  instituted, 
which  have  led  to  the  following  conclusions : — 1st.  That  arterial 
blood  supplied  to  an  inflamed  limb  is  less  warm  than  the  seat  of 
inflammation;  2d.  That  the  venous  blood  returning  from  an 
inflamed  limb,  though  less  warm  than  the  focus  of  inflammation, 
is  warmer  than  the  arterial  blood  supplied  to  it ;  and  Sd.  That  the 
venous  blood  returning  from  an  inflamed  limb  is  warmer  than 
the  corresponding  current  on  the  opposite  side  of  the  body.  On 
the  evidence  of  these  experiments,  which  were  made  on  three 
dogs  with  compound  fracture  of  the  leg,  Mr.  Simon  ventures  to 
say  that  the  inflamed  part  is  no  mere  recipient  of  heat,  but  is 
itself  actively  calorific;  and  that  in  proportion  to  its  heated 
venous  outflow  the  temperature  of  the  common  mass  of  circu- 
lating blood  is  necessarily  raised ;  and  that  the  local  disorder 
represents  an  influence  which  tends  to  diffusion  throughout  the 
body,  and  thus  be  an  important  cause  of  inflammatory  fever. 

Impairment  of  Function. — Perversion  or  impairment  of  the 
functional  properties  of  a  part  under  inflammation  is  a  very 
common,  indeed  almost  a  constant,  accompaniment  of  its  various 
stages.     In  the  first   stage  it  may  be  increased,  as  may  be- 


CHRONIC  INFLAMMATION.  25 

witnessed  in  the  delirium  of  the  first  stage  of  phrenitis,  and 
almost  suspended  during  the  comatose  or  later  stage.  In 
enteritis  it  is  often  found  that  the  bowels  will  act  excitedly, 
small  quantities  of  fseces  being  passed  very  frequently  at  the 
commencement  of  that  disease,  but  at  a  later  stage  their  action 
will  be  entirely  suspended. 

In  inflammation  of  the  muscles,  again,  we  find  that  there  is 
almost  total  loss  of  their  proper  contractile  power,  and  that 
what  remains  of  it  is  brought  into  action  with  difficulty  and 
pain ;  showing  that  though  their  functional  activity  is  lost,  their 
sensibility  is  highly  exalted. 

CHRONIC  INFLAMMATION. 

Inflammations,  according  to  the  severity  of  their  causes,  and 
duration  of  their  action,  manifest  certain  alterations  in  their 
progress  and  termination,  and  the  terms  acute,  sub-acute,  and 
chronic  have  reference  to  the  periods  of  the  duration  of  the 
inflammation,  or  the  rapidity  or  slowness  of  its  course. 

In  chronic  inflammation  the  action  of  the  irritant,  though  less 
immediate  and  severe,  is  much  more  prolonged,  and  has  a  greater 
tendency  to  excite  the  formation  of  an  abundance  of  tissue, 
which,  though  less  highly  organized  than  the  normal,  yet  is  not 
so  prone  to  undergo  those  retrogressive  changes  which  charac- 
terise the  exudates  of  acute  inflammation. 

Whilst  the  more  highly  vascular  organs  are  by  no  means 
exempt  from  chronic  inflammation,  it  is  found  that  the  less  or 
non-vascular  tissues  more  commonly  undergo  those  changes 
which  characterise  it ;  changes  due  either  to  the  nature  of  the 
irritant,  the  vital  tone  of  the  tissue  irritated,  or  to  the  strength 
of  the  cause  being  insufficient  to  excite  the  more  acute  and 
rapid  inflammation. 

Chronic  inflammation  may  run  its  course  independently  of  the 
acute ;  it  may  also  supervene  or  precede  it ;  but  generally  the 
milder  it  is  at  the  outset,  and  the  more  prolonged  in  its  course, 
the  more  highly  organized  and  more  permanent  will  be  its  pro- 
ducts. From  this  it  will  be  gathered  that  chronic  inflammation 
— unimportant  perhaps  when  not  located  in  vital  organs — 
becomes  exceedingly  grave  when  involving  organs  or  tissues 
essential  to  life,  inasmuch  as  the  inflammatory  new  formation 


26  INFLAMMATION. 

may  so  press  upon  or  even  destroy  the  structure  of  an  organ  as 
to  render  it  incapable  of  performing  its  function. 

Of  this  we  have  examples  in  consolidation  of  the  lungs, 
cirrhosis  of  the  liver,  &c. 

There  are  some  chronic  inflammations  which  are  essentially 
destructive  to  the  tissue  which  they  involve,  and  in  which  there 
is  no  tendency  to  the  formation  of  new  tissue  in  the  inflamed 
part  itself — as,  for  example,  in  inflammation  of  articular  cartil- 
age ;  but  even  in  these,  with  but  few  exceptions,  there  is  an 
increased  formation  of  fibrous,  and  even  more  highly  organized 
tissue,  i.e.,  bone,  in  close  proximity  to  the  focus  of  inflammation. 


TERMINATIONS  OF  INFLAMMATION. 

Many  pathologists  are  of  opinion  that  there  are  great  objec- 
tions to  the  expression  used  here,  and  that  what  are  regarded 
as  terminations  are  conditions  co-existent  with  the  various 
stages  of  inflammation.  Some  have  even  gone  so  far  as  to  say 
that  resolution  is  not  a  termination ;  but  we  must  at  least  retain 
that  term,  as  it  seems  the  only  termination.  The  words  results, 
or  events,  are  now  used  instead  of  terminations ;  and,  retaining 
resolution  as  a  termination,  these  are — Effusion  of  Serum,  Exu- 
dation of  Coagulable  Lymjph,  Suppuration,  Ulceration,  Gangrene, 
and  Sphacehcs. 

RESOLUTION. 

This  is  said  to  occur  when  the  symptoms  gradually  subside, 
and  when  there  is  a  cessation  of  the  transudation  of  the  fluid 
part  of  the  blood  from  the  vessels ;  or,  in  other  words,  a  resto- 
ration of  the  nutritive  functions  of  the  part  into  their  normal 
condition,  and  the  absorption  of  the  substance  contained  in  the 
tissue.  This  subsidence  of  inflammation  may  be  sudden,  when 
it  is  called  delitescence;  or  it  may  be  gradual,  when  it  is 
called  resolution ;  or  it  may  be  sudden,  and  the  inflammation 
may  as  suddenly  appear  in  another  part  of  the  body,  and  then 
metastasis  is  said  to  have  taken  place. 

Eesolution  occurs  in  two  ways : —  1st.  The  sudden  cessation  of 
the  irritation,  delitescence,  and  removal  of  the  exuded  materials 
before  coagulation  or  solidification  has  been  effected.  In  this 
process  the  veins  and  lymphatics  take  up  the  exudate  in  its 


TERMINATIONS  OF  INFLAMMATION.  27 

normal  fluid  condition,  as  it  occurs  in  ordinary  serum  when 
blood  is  drawn  from  the  body  before  the  fibrine  has  coagulated. 

2d.  The  exudation  is  more  complete,  the  exuded  lymph  is 
consolidated,  or  even  transformed  into  a  low  form  of  fibrous 
tissue,  surrounded  by  and  soaked  in  much  serosity.  At  this 
point  its  organization  is  arrested,  the  contents  of  the  cells  con- 
verted into  fatty  granules,  the  cell  walls  break  down,  the  granules 
escape  into  the  surrounding  fluid  (serosity),  forming  the  so-called 
"  pathological  milk  " — a  fluid  similar  to  chyle.  In  this  condition 
it  is  absorbed  into  the  circulation,  and  after  undergoing  other 
transformations  whilst  mixed  with  the  blood — converted  into 
urea,  hippurates,  ammonia,  carbonic  acid,  &c. — is  finally  ejected 
from  the  system  by  the  excretory  organs,  leaving  the  inflamed 
part  in  its  original  condition,  or  perhaps  slightly  altered. 

The  termination  which  has  been  called  "  Adhesion  "  is  another 
method  by  which  the  exudate  is  disposed  of,  and  presents  a  more 
complete  and  higher  organization  of  the  lymph  than  the  former. 
In  this  process  the  cells,  instead  of  undergoing  fatty  degenera- 
tion, become  developed  into  a  form  of  fibrous  tissue,  which  in 
the  course  of  time  becomes  vascular  by  the  formation  of  new 
blood-vessels  within  its  substance ;  and  whilst  organization  is 
going  on  in  the  tissue,  the  surrounding  serum  is  absorbed, 
leaving  the  new  formation  as  part  of  the  economy,  remain- 
ing so,  as  in  the  adhesions  of  pleuritis,  &c.,  throughout  the 
animal's  life. 

The  formation  of  the  new  blood-vessels  is  very  interesting, 
and  is  supposed  to  be  effected  as  follows : — Coincident  with  the 
structural  development  of  the  cells  and  intermediate  substance 
into  connective  tissue,  new  blood-vessels  are  formed  by  outgrowths 
from  the  walls  of  the  original  vessels  of  the  surrounding  parts. 
These  outgrowths  first  appear  as  slight  pouches  on  several 
original  vessels  ;  these  pouches  or  dilatations  first  present  them- 
selves on  one  point  of  a  vessel,  then  on  another,  as  if  its 
waUs  yielded  a  little;  they  gradually  extend  themselves  as 
blind  canals  from  the  original  vessels,  directing  their  course 
towards  the  edge  or  surface  of  the  new  material,  and  are 
crowded  with  blood  globules,  which  are  pushed  into  them  from 
the  main  stream.  Still  extending,  they  converge  and  meet ; 
the  partition  wall  that  is  at  first  formed  by  the  meeting  of  their 
closed  ends  clears  away,  and  a  perfect  arched  tubs  is  thus  made. 


28  INFLAMMATION. 

tlirongli  which  the  blood,  diverging  from  the  main  stream,  and 
tlien  rejoining  it,  may  be  continuously  propelled :  or  a  delicate 
threadlike  process  shoots  from  a  vessel,  and  becomes  connected 
with  corresponding  shoots  from  otlier  vessels.  These  fine  pro- 
cesses widen  out,  become  tubular,  and  their  cavities  form  canals 
continuous  with  those  of  the  parent  vessels.  When  the  new 
blood-vessel  has  begun  to  project  it  sometimes  bursts ;  the  blood- 
globules  that  issue  from  the  ruptured  pouch  collect  in  an  un- 
certain mass  within  the  tissue  like  a  mere  ecchymosis,  but  before 
long  they  manifest  a  definite  direction ;  and  the  cluster  bends 
towards  the  line  in  which  the  new  blood-vessel  micfht  have 
formed,  and  opens  into  a  portion  of  the  arch,  or  into  some 
adjacent  vessel.  For  this  mode  of  formation  from  vessels  the 
name  of  channelling  seems  appropriate,  for  it  appears  certain 
that  the  blood-globules  here  make  their  way  in  the  parenchyma 
of  the  tissue  unconfined  by  membranous  walls.  The  new  vessels 
possess  a  very  simple  structure,  their  walls  being  a  thin  mem- 
brane with  imbedded  nuclei. — (Virchow,  Paget.) 

Effusion  differs  from  the  so-called  exudation  of  lymph  in 
the  fact  that  it  occurs  from  the  surface  of  serous  membranes, 
blisters  on  the  skin,  or  in  a  very  loose  areolar  tissue,  where  the 
process  of  perverted  nutrition  is  of  the  most  rapid  kind. 

The  fluid  found  in  serous  cavities  and  in  serous  abscesses 
partakes  of  the  general  characters  of  the  serum  of  the  blood 
slightly  modified,  being  of  a  higher  specific  gravity  and  con- 
taining more  albumen,  with  more  or  less  fibrine.  Many  speci- 
mens of  the  effusion  found  in  pleuritis,  for  example,  contain 
fibrine  in  an  imperfectly  developed  condition — fibrine  which 
does  not  coagulate  until  it  is  exposed  to  the  atmosphere. 

Now,  if  the  fibrine  were  transuded  through  the  walls  of  the 
vessels,  it  would  in  all  cases  coagulate  within  the  body;  but 
when,  owing  to  the  inflammation  being  near  or  upon  the  surface, 
or  in  very  loose  areolar  tissue,  the  transformation  of  the  transuded 
material  takes  place  rapidly,  and  hence  imperfectly — that  is  to 
say,  when  the  fluid  sweats  through  the  walls  of  the  cells  in 
an  imperfectly  developed  condition,  or,  when  occurring  upon 
a  serous  membrane  (it  is  also  the  case  in  a  mucous  membrane), 
the  epithelial  scales  are  rapidly  thrown  off,  along  with  the  fluid 
they  secrete. 

In   many   effusions    we   find    completely   developed   fibrine 


RESOLUTION".  29 

floating  in  the  liquid,  and  often  forming  bands  of  adhesion 
between  the  opposing  surfaces  of  the  intiamed  membrane. 

In  every  instance  of  undoubted  pleuritis,  effusion  of  serum 
takes  place ;  and  it  is  ridiculous  to  hear  some  speak  of  the 
differences  that  are  observable  in  the  symptoms  when  this  occurs, 
and  of  the  great  danger  to  be  apprehended.  The  effusion  is  part 
and  parcel  of  the  process  of  inflammation  from  almost  the  outset, 
and  the  only  danger  is  owing  either  to  the  constitution  of  the 
animal  being  bad,  or  the  treatment  irrational,  or  the  attack  of 
more  than  ordinary  severity,  that  the  effusion  may  become 
excessive,  and  cause  death  by  suffocation. 

Serous  effusion  is  sometimes  the  result  of  mechanical  con- 
gestion, as  witnessed  in  oedema  of  the  extremities,  in  ascites, 
from  disease  of  the  liver,  spleen,  or  heart,  but  this  is  totally 
unconnected  wdth  inflammation ;  in  such  instances  the  fluid  is 
clear,  and  generally  contains  but  little  fibrine,  or  any  substance 
that  coagulates  upon  exposure  to  the  air. 

The  formation  of  a  non-coaojulatinsc  effusion  in  the  various 
cavities  is  very  propitious;  for  so  long  as  it  remains  liquid, 
absorption  may  still  ensue  without  its  undergoing  any  ulterior 
changes  when  the  inflammation  subsides.  The  subsidence  of 
the  inflammatory  action,  however,  is  necessary,  for,  from  what 
has  been  already  said,  there  is  impairment  of  function,  and 
absorption  does  not  readily  take  place. 

It  has  been  shown  by  Beale,  Simon,  and  others,  that  there 
are  two  essential  characteristics  of  inflammatory  effusion : — 
IsL  It  contains  certain  ingredients  in  larger  proportion  than  that 
in  which  they  exist  in  the  blood — excess  of  chloride  of  sodium, 
of  phosphates,  and  albumen ;  and  2d.,  organic  germs  find  in  it  a 
suitable  place  for  growth. 

BLOOD  EFFUSION,  OE  EXTRAVASATION. 

This  occurs  chiefly  from  rupture  of  new  blood-vessels  de- 
veloped in  the  newly-formed  material  which  has  just  become 
vascular. — (Eokitansky.)  But  we  find  it  w^hen  there  has  been 
no  time  for  the  formation  of  such  new  vessels,  namely,  at  the 
very  commencement  of  an  acute  inflammation  of  the  substance 
of  the  lungs ;  but  this  is  rare,  and  betokens  either  a  very  bad 
constitution,  or  that  the  inflammation  is  due  to  a  very  malignant 


30  INFLAMMATION. 

epizootic  influence,  or  that  it  arises  from  that  condition  of  blood 
observable  in  purpura.  These  haemorrhages  must  not,  however, 
be  confounded  with  blood-staining  of  the  part  through  the 
oozinor  of  some  of  the  colourincf  matter  of  the  blood.  The 
natural  colour  of  the  inflammatory  new  formations  is  greyish  or 
yellowish -white  (straw  colour  very  often);  and  even  when  they 
contain  blood-vessels,  this  opacity  prevents  their  having  any 
uniform  tinge  of  redness  when  they  are  recent.  (Example — 
Surface  of  lung  in  pleuro-pneumonia.)  When  they  present  a 
tinf^e  of  redness,  it  is  either  because  of  hsemorrhage  into  them, 
or  because  they  have  imbibed  the  dissolved  colouring  matter  of 
the  blood  (hsematodine) ;  and  when  this  imbibition  happens 
during  life,  or  soon  after  death,  it  is  important,  as  indicating  an 
ill-conditioned  state  of  the  blood,  in  which  the  colouring  matter 
of  the  corpuscles  becomes  unnaturally  soluble. 


CHAPTER  11. 

TERMINATIONS  OF  INFLAMMATION — Continued. 

SUPPURATION — ACUTE  ABSCESS DIFFUSE  SUPPURATION — SUPERFICIAL 

SUPPURATION COMPARISON    BETWEEN    MUCUS,    EPITHELIUM,   AND 

PUS PYOGENIC  FEVER,  OR  STRANGLES PYEMIA RE-ABSORPTION 

OF  PUS FORMATION  OF  SINUSES ULCERATION VARIETIES  AND 

TREATMENT  OF  ULCERS — MORTIFICATION. 

The  formation  of  pus  is  termed  suppicrafion,  and  it  takes  place 
in  three  distinct  ways — (1.)  circumscribed ;  (2.)  diffused ;  and 
(3.)  superficial  suppurations. 

As  an  example  of  the  first  or  circumscribed  form,  I  shall  take 
what  is  called  an  abscess  or  phlegmon,  in  which  the  suppura- 
tion is  enclosed  in  a  cavity  (as  in  the  abscess  of  strangles) 
whose  walls  are  composed  of  areolar  tissue.  In  the  first  stage, 
the  cells  of  the  connective  or  areolar  tissue  are  charged  with 
the  material  (lymph)  formed  by  them  during  the  first  stage  of 
the  inflammation;  there  is  an  enlargement  of  the  cells,  their 
nuclei  divide,  and  for  some  time  multiply  excessively.  This 
is  soon  followed  by  division  of  the  cells  themselves,  and  round 
about  the  irritated  or  inflamed  parts,  where  single  cells  formerly 
lay,  pairs  or  groups  of  cells  are  subsequently  found,  out  of 
which  a  new  formation  (connective  tissue)  grows.  In  the  in- 
terior of  this  growth,  where  the  cells  were  at  an  early  period 
abundantly  filled  with  nuclei,  numberless  little  cells  soon  ap- 
pear, which  at  first  still  preserve  the  direction  and  forms  of  the 
previous  connective  tissue  corpuscles. 

These  accumulations  of  little  cells  occur  somewhat  later,  as 
diffuse  infiltrations  of  roundish  masses  encircled  by  the  inter- 


32 


TERMINATIONS  OF  INFLAMMATION. 


mediate  tissue,  which  continually  liquefies  and  becomes  more 

and   more   scanty  as  the  pro- 


liferation of  the  cells  extends. 
It  is  held  that  this  liquefaction 
is  of  a  chemical  nature;  the 
intermediate  substance  (which 
is  of  a  glutinous  nature)  be- 
comes converted  ultimately  into 
an  albuminous  fluid,  and  is  ren- 
Fig  5  -Purulent  granulations  from    ^ered  liquid.     We  thus  see  that 

the  subcutaneous  tissue  of  a  rabbit  round  .      •"■ 

about  a  ligature,     a.   Connective  tissue     pUS    is    UOt    derived    from    auy 

corpuscles.     6    Enlargement  of  the  cor-  effusiou,  but    that  it  is    formed 
puscles,   with  division  of  the  nuclei,     c.  . 

Division  of  the  cells  (granulations),     d.  by  vital    changCS  in  the    gCrmS 

(vTrchowT'  '^   '^'   ^^'  corpuscles.-  ^f    ^^^^    ^^g^^^^^    ^^^    ^^^^^^  ^^    ^ 

slight  modification  of  the  same 
process,  new  connective  tissue  is  formed.     The  outmost  layer 

of  the  intercellular  tissue  is 
often    long   preserved,  whilst 


all  its  deeper  parts  are  already 
filled  with  pus  corpuscles, 
or  are  converted  into  an 
abscess ;  at  last  the  surface 
gives  way,  or,  without  giving 
way,  is  directly  transformed 
into  a  soft  diftluent  mass. — 
(VmcHow.) 

Examples  op  Cells.  ^  ' 

Fig.  Q.-a,  a.  Young  cells,      h  and  c.  ^he     pUS     itself     waS     for- 

Connecting  tissue  cells  ;  and  d.  Pus  cell,  mcrly  thought  tO  have  Solvcnt 
all  derived  from  a.                         •  , .  a    J_^     l     -k         l^  • 

properties,  and  that  by  this 
power  it  was  enabled  to  find  its  w^ay  to  the  surface,  but  experi- 
ments have  proved  this  to  be  incorrect.  Bones  have  been 
placed  in  cavities  full  of  pus,  and  left  there  for  weeks,  and 
wdien  they  were  afterwards  weighed,  they  have,  if  anything, 
become  heavier,  tlirough  the  absorption  of  fluid  matters,  but  no 
softening  has  been  produced,  except  that  caused  by  decomposi- 
tion. How  far  the  tissue  is  destroyed  by  solution  chiefly  de- 
pends upon  the  question  whether  the  substance  that  surrounds 
the  young  cells  becomes  completely  fluid.  If  it  retains  a  cer- 
tain degree  of  consistence,  the  process  is  confined  to  the  pro- 
duction of  granulations,  and  these  may  as  well  proceed  from  a 


SUPPURATION. 


33 


surface  whose  continuity  is  perfect,  as  from  one  in  whicli  there 
is  a  breach.  In  every  case  granulations  arise  out  of  the  tissue, 
and  it  is  not  essential  tliere  should  be  loss  of  substance ;  they 
are  found  upon  bone  without  any  loss  of  substance  having  pre- 
ceded them.  They  are  found  also  in  direct  contact  with  the 
cutis  under  intact  epidermis,  and  with  mucous  membranes ;  and 
only  in  proportion  as  they  become  developed  do  the  mucous 
membranes  lose  their  normal  character. 

Well-formed,  perfectly  ela- 
borated, healthy  pus  is  a  smooth, 
rather  greasy,  sometimes  viscid, 
yellowish-white,  or  cream-col- 
oured substance,  of  a  higher 
specific  gravity  than  water,  aver- 
aging generally  about  1'030 
having  little  or  no  smell,  and  of 
an  alkaline  reaction.  Microsco- 
pically it  is  found  to  consist  of 
certain  essential  constituents, 
namely,  pus  corpuscles ;  which 
measure  about  g-sVu  ^^  ^-^'otj 
of  an  inch  in  diameter,  are  pel- 
lucid, filled  with  semi-fluid 
albuminous  contents,  and  some- 
times containing  a  few  minute 
oil  globules.      Along  with  the 


Fig.  7. — Cells  from  fresh  catarrhal 
spvita.  A.  Pus  corpuscles,  a.  Quite  fresh. 
h.  When  treated  with  acetic  acid.  Within 
the  membrane  the  contents  have  cleared 
up,  and  three  little  nuclei  are  seen. 
B.  Mucus  corpuscles,  a.  A  simple  one. 
h.  Containing  pigment  granules.  300 
diameters.  —  ( V  i  rchovv,  ) 


I 


B 


pus  cells  floating  in  the  clear 
liquor  puris  are  often  seen 
minute  clear  particles,  which 
seem  to  have  some  relation,  as 
nuclei  or  rudiments  of  the  cells. 


!FiG,  8. — A.  Pus  corpuscles,  a.  Fresh. 
b.  After  the  addition  of  a  little  watei-. 
c-e.  After  treatment  with  acetic  acid, 
the  contents  cleared  up,  the  nuclei 
which  were  in  process  of  division,  or 
already  divided,  visible  at  e,  with  a  slight 
depression  on  their  surface.     B.  Nuclei 

These  minute  particles  are  not   of  pus  corpuscles,    a.  Simple  nucleus 

J ,  ,  r.  .      ,     .        with  nucleoli,  b.  Ii 

more  tlian  i-o-,VTr-D  oi  ^^^  ^^^h  m 
These   two  solid  consti- 


ncipient  division,  with 
depressions*  on  the  surface  of  the  nuclei, 
c.  Progressive  bi-partition.  d.  Tri-par- 
tition.  C.  Pus  corpuscles  in  their  natu- 
ral position  with  regard  to  one  another, 
500  diameters.  — ( ViBCHOW. ) 


Size. 

tuents  float  in  a  fluid  or  serum, 

called  the  liquor  ^;?«7"ts,  and  the 

shape   of  the  cells  depends  on 

the  density  of  this  liquor  puris. 

dark-edged  nucleus  may  be  seen  in  the  paler  corpuscles,  and 

sometimes  two  or  even  three  particles,  like  a  divided  nucleus. 


*  By  many  held  to  be  nucleoli. 

Sometimes  a  distinct,  circular, 


34  TERMINATIONS  OF  INFLAMMATION. 

These,  then,  are  the  component  parts  of  good,  healthy,  or 
laudable  pus,  showing  a  benign  form  of  inflammation,  and 
that  the  disease  is  going  on  regularly  and  promises  a  for- 
tunate issue.  When,  however,  the  process  deviates  from  the 
usual  course  in  an  animal  otherwise  healthy,  variations  are 
found  in  the  cells,  with  multiform  mixtures  of  withered  cells ; 
molecular  and  fatty  matter;  escaped  and  shrivelled  nuclei, 
blood  corpuscles,  and  fragments  of  fibrogenous  material;  the 
liquor  puris  is  thin,  liquid,  or  watery,  and  the  pus  is  then 
said  to  be  ichorous.  When  the  colouring  matter  of  the  blood 
is  mixed  with  it,  it  is  called  sanies,  or  sanious  pus. 

Many  chemical  and  vital  changes  are  found  to  bring  about 
a  decomposition  in  pus  while  yet  in  contact  with  living  parts, 
although  it  is  probable  that  germs  in  the  atmosphere,  or  gases 
formed  within  the  body,  may  have  to  do  with  the  change ;  but 
phosphuretted  and  sulphuretted  hydrogen  and  ammonia  will  be 
found  frequently  developed  in  abscesses,  especially  if  the  pus  be 
in  contact  with  bone,  or  near  the  alimentary  canal,  or  in  the  foot : 
the  smell  is  then  most  offensive ;  it  is  then  called  fcetid  pus. 
Pus  may  also  contain  certain  specific  properties ;  that  is  to  say, 
it  may  be  impregnated  with  certain  specific  poisons,  as  that  of 
glanders,  variola,  &c. 

Healthy  or  laudable  pus  has  no  smell,  except  that  peculiar 
to  the  animal  in  which  it  may  exist ;  it  has  an  alkaline 
reaction  when  freshly  drawn  from  an  abscess,  but  it  readily 
becomes  acid  from  the  generation  of  what  is  supposed  to  be 
lactic  acid. 

It  will  be  gathered  from  the  foregoing  remarks  that  the 
boundary  or  wall  of  an  abscess  consists  of  newly  formed  areolar 
tissue,  which  has  maintained  the  firmness  and  solidity  of  the 
part  by  activity  of  nuclear  growth.  There  is  sometimes  found 
to  be  a  thin,  opaque,  yellowish-white  layer,  easily  detached, 
separating  the  suppuration  from  the  denser  part.  This  has 
been  called  pyogenic  memhrane,  from  the  supposition  that  its 
function  is  to  secrete  the  pus ;  whereas  the  cells  of  the  denser 
part  are — by  premature  and  continuous  development — growing 
into  pus  cells ;  that  is  to  say,  there  is  no  secretion  of  pus  by 
any  membrane,  but  a  continual  formation  of  it  by  proliferation 
of  the  cells  proper  to  the  part. 

When  suppuration  takes  place  in  the  cavities  of  the  body,  it 


SUPPURATION.  35 

is  still  circumscribed ;  however,  it  is  not  called  an  abscess,  but 
"  purulent  effusion." 

Abscesses  are  occasionally  found  to  exist  without  the  usual 
signs  of  inflammation ;  they  are  then  called  "  cold  abscesses ; " 
and  when  slowly  formed,  chronic  or  old  abscesses. 

Abscesses  are  divided  into  acute  and  chronic. 


ACUTE  ABSCESS. 

Symptoms. — Symptoms  of  inflammation  precede  the  sup- 
puration ;  there  is  heat,  pain,  and  swelling  in  the  part,  with 
more  or  less  symptomatic  fever;  for  a  time  the  pain  increases, 
and  changes  to  a  throbbing  character.  The  swelling  becomes 
harder  from  increased  exudation,  and  when  the  abscess  is  deeply 
situated,  tliere  is  some  oedema  of  the  surrounding  areolar  tissue. 
Concomitant  with  these  symptoms,  a  tendency  to  rigor  or 
shivering  may  be  observed  by  the  staring  coat,  or  actual  rigors 
of  a  severe  character  may  occur. 

In  the  centre  of  the  swelling  pus  is  formed,  and  around  this 
a  layer  of  condensed  plastic  lymph,  being  the  boundary  or 
cyst  of  the  abscess.  The  quantity  of  pus  increases,  and  b}^  its 
presence  causes  the  absorption  of  the  boundary  of  the  abscess, 
more  particularly  of  that  portion  nearest  to  the  free  surfaces  of 
the  body,  generally  the  skin.  The  swelling  becomes  soft  in  the 
middle,  but  continues  hard  at  the  base,  and  oedematous  at  a 
greater  distance.  The  next  chans^e  is  the  elevation  of  the  centre 
into  a  prominent  hairless  spot.  This  is  called  the  pointing  of 
the  abscess. 

In  general,  some  time  before  the  abscess  points,  fluctuation 
is  discoverable,  particularly  if  it  is  superficially  situated ;  but 
if  deep-seated,  and  where  the  superimposed  structures  are  still 
tense  and  thick,  the  quantity  of  pus  but  scanty,  the  perception 
of  fluid  is  obscure;  it  becomes,  however,  more  and  more  dis- 
tinct as  the  tissues  external  to  it  become  thinner. 

A  noticeable  feature  in  the  pointing  of  an  abscess  in  the 
lower  animals  is  the  removal  of  the  hairs,  these  falling  off  and 
leaving  a  bare  spot  on  the  most  prominent  part  of  the  swelling. 
This  is  accounted  for  by  the  absorption  of  the  skin  and  destruc- 
tion of  the  hair  follicles,  which  take  place  before  the  abscess 
finally  bursts.     When   the   collection   of  matter  is  small,  or 


so  TERMINATIONS  OF  INFLAMMATION. 

thickly  covered,  a  very  nice-practised  sense  of  toucli,  the  tactiis 
eruditus,  is  requisite  for  detecting  its  presence ;  but  if  the 
abscess  be  large  or  superficial,  simple  palpation  at  one  point  is 
sufficient  to  detect  it. 

In  feeling  for  fluctuation,  the  points  of  the  fingers  of  one 
hand  are  placed  on  the  dependent  part  of  the  abscess,  whilst 
with  the  fingers  of  the  other  hand  the  upper  part  of  the  swell- 
ing is  gently  pressed  or  tapped,  when  the  undulations  of  the  pus 
will  be  distinctly  felt. 

In  the  treatment  of  acute  abscess  soothing  remedies  are  the 
most  useful,  and  of  these  heat  and  moisture  are  the  best,  as 
they  not  only  soothe,  but  promote  the  formation  and  growth 
of  pus.  They  should  consist  of  warm  fomentations  and 
poultices,  and  if  the  pain  be  excessive,  anodynes  may  be  given 
internally  and  applied  locally.  As  soon  as  pus  is  formed,  a  free 
incision  should  be  made  into  the  abscess,  to  allow  its  ready 
escape ;  then  a  warm  poultice  is  to  be  applied  for  a  few  days, 
but  a  long-continued  application  of  poultices  is  apt  to  give 
rise  to  weak  action  in  the  cavity  of  the  abscess.  There  is  no 
necessity  for  violently  squeezing  the  abscess  after  it  is  opened, 
nor  to  introduce  pledgets  of  tow  into  it,  as  practised  by  some. 
After  the  removal  of  the  poultice  all  that  is  necessary  is  to  keep 
the  parts  clean,  and  apply  a  weak  solution  of  carbolic  acid  to 
the  lips  of  the  wound.  Generally,  abscesses  should  be  opened ; 
they  should  always  be  opened  when  too  deep-seated  to  point ; 
but  abscesses  in  the  neighbourhood  of  a  joint  should  be  treated 
with  great  caution,  and,  as  a  rule,  allowed  to  burst  spontaneously. 
The  abscess  of  simple  strangles  should  not,  in  my  opinion,  be 
opened,  but  allowed  to  run  its  natural  course. 

The  best  instrument  for  opening  an  abscess  is  Syme's  abscess 
knife,  the  point  to  be  inserted,  and  the  opening  so  made  enlarged 
as  the  knife  is  withdrawn. 


DIFFUSE  SUPPURATION. 

We  have  examples  of  this  in  purulent  infiltration  of  an  organ, 
as  in  the  lungs  in  acute  glanders.  The  inflammation  extends 
through  a  wide  extent  of  tissue,  and  the  boundaries  of  the  dis- 
ease are  ill  defined.  The  development  and  growth  of  the  pus 
cells  is  exceedingly  rapid,  the  tissue  being  as  if  soaked  in  pus, 


DIFFUSE  SUPPUEATION.  37 

and  should  the  aiiiinal  not  die  quickly,  large  sloughs  or  death 
of  portions  of  structure  may  take  place. 

formation  of  pus,  occurring  in  loose  texture — the  popliteal 
space,  poll,  withers — may  cause  infiltration  by  gravity,  thus 
leading  to  a  secondary  destruction  of  tissue,  and  the  formation 
of  sinuses. 

The  progress  of  purulent  effusion  is  probably  not  dissimilar 
to  that  of  the  phlegmonous  abscess,  but  the  inflammation  is  of 
a  different  type,  and  all  the  processes  less  complete.  Thus  we 
find  no  barrier  of  condensed  tissue  to  circumscribe  the  abscess, 
or  limit  the  pus.  The  process  of  suppuration  is  less  per- 
fect, so  that  the  pus  contains  shreds  or  even  large  portions 
of  mortified  and  loose  connective  tissue.  There  is  no  vital 
transformation  into  a  fluid  albuminous  substance  here,  as  in  a 
healthy  abscess.  The  pus  is  also  thinner,  containing  a  large 
portion  of  liquor  puris,  and  also  sometimes  flakes  of  lymph. 
There  is  no  pointing,  as  in  true  abscess,  for  the  pus  passes 
readily  frorn  its  original  seat  by  gravitation  towards  the  most 
depending  position,  presenting  a  soft,  broad  surface,  without  any 
indication  of  pointing.  I  have  often  seen  these  collections  of 
pus  not  only  in  the  lungs  of  glandered  horses,  but  in  the  lungs 
of  horned  cattle,  that  have  survived  and  apparently  recovered 
from  pleuro -pneumonia. 

Wounds  on  the  gluteal  region,  more  especially  near  the 
tuberosity  of  the  ischium,  are  apt  to  cause  very  extensive  infil- 
tration of  pus  throughout  the  inter-muscular  areolar  tissue  of 
the  thigh.  Very  often,  after  an  apparent  recovery  from  a 
wound  in  this  region,  the  lower  part  of  the  thigh  will  begin  to 
swell,  and  on  examination  the  enlargement  will  be  found  to  con- 
tain a  large  quantity  of  pus,  extending,  perhaps,  from  immediately 
above  the  hock  to  the  groin,  the  pus  having  burrowed  from  the 
wound  above,  and  by  gravitation  forced  its  way  down  among  the 
tendons  of  the  various  muscles.  Sometimes  there  are  direct 
signs  of  pointing,  sometimes  not.  All  such  collections,  wherever 
situated,  should  be  removed  by  puncturing  the  lowest  part  of 
the  swelling. 

SUPERFICIAL  SUPPURATION 

May  be  witnessed  in  inflammation  of  mucous  membranes  and 
the  skin,  and  the  growth  of  pus  can  be  clearly  traced  whei*e 


33  TERMINATIONS  OF  INFLAMMATION. 

columnar  and  stratified  epithelium  exists.     I  shall  here  quote 
from  Virchow,  who  says : — "  If  you  follow  the  development  of 
pus  upon  the   skin,  when  the   process  is  unaccompanied  by 
ulceration,  you  will  constantly  see  that  the   suppuration  pro- 
ceeds from   the  rete   malphigi.     It  consists  in  a  growth   and 
development  of  new  cells  in  this  part  of  the  cuticle.     In  pro- 
portion as  these  cells  proliferate,  a  separation  of  the  harder 
layers  of  the  epidermis  ensues,  and  they  are  lifted  up  in  the 
form  of  a  vesicle  or  pustule.     The  place  where  the  suppuration 
chiefly  occurs  corresponds  to  the  superficial  layers  of  the  rete, 
which  is  already  in  process  of  conversion  into  epithelium ;  if 
the  membrane  of  the  vesicle  be  stripped  of,  this  layer  usually 
adheres  to  the  epidermis,  and  is  stripped  off  with  it.      In  the 
deeper  layers  we  may  watch  how  the  cellular  elements,  which 
originally  have  only  single  nuclei,  divide,  and  how  their  nuclei 
become  more  abundant,  and  single  cells  have  their  places  taken 
by  several,  which  in  their  turn  again  provide  themselves  with 
dividing  nuclei.     Here,  too,  people  have  generally  helped  them- 
selves out  of  the  difficulty  by  assuming  that,  in  the  first  in- 
stance, an  exudation  was  poured  out,  which  produced  the  pus 
in  itself,  and  this  is  the  reason  why  most  investigators  into  the 
development  of  pus  especially  selected  fluids  which  were  secreted 
from  injured  surfaces.     It  was  very  conceivable  that,  as  long 
as  no  doubts  were  entertained  with  regard  to  discontinuous 
formation  of  cells,  the  young  cells  should,  without  more  in- 
quiry, be  looked  upon  as  independent  new  formations;    and 
that  the  notion  should  be  entertained  that  germs  arose  in  the 
exuded  fluids,  and  gradually  becoming  more  numerous,  supplied 
the  pus.     But  the  matter  stands  really  thus  : — The  longer  the 
suppuration  lasts,  the  more  certainly  is  one  series  of  cells  after 
the  other  in  the  rete  involved  in  the  process  of  proliferation, 
and  whilst  the  vesicle  is  rising  up,  the  quantity  of  the  cells 
which  grow  into   its   cavity  is   constantly   becoming   greater. 
When  a  variolous  pustule  forms,  there  is  at  first  only  a  drop  of 
clear  fluid  present,  but  nothing  arises  in  it ;  it  only  loosens  the 
neighbouring  parts  of  the  rete  malphigi. 

"  Precisely  the  same  is  the  case  with  mucous  membranes. 
There  is  not  a  single  mucous  membrane  which  may  not,  under 
certain  circumstances,  furnish  puriform  elements.  But  here, 
too,  a  certain   difference   always   presents   itself     A   mucous 


SUPERFICIAL  SUPPURATION.  '39 

membrane  is  all  the  more  in  a  condition  to  produce  pus  without 
ulceration  the  more  completely  the  epithelium  which  it  possesses 
is  stratified.  All  mucous  membranes  with  a  single  layer  of 
cylindrical  epithelium  (intestines)  are  much  less  adapted  to  the 
production  of  pus  ;  that  which  is  produced  on  them,  even  though 
it  has  quite  the  appearance  of  pus,  frequently  turns  out,  upon 
close  examination,  to  be  only  epithelium.  The  intestinal 
mucous  membrane,  especially  that  of  the  small  intestines, 
scarcely  ever  produces  pus  without  ulceration.  The  mucous 
membrane  of  the  uterus,  and  of  the  fallopian  tubes,  though  it 
is  frequently  covered  with  a  thick  mass  of  quite  a  puriform 
appearance,  almost  always  secretes  epithelial  cells  only ;  whilst 
on  other  mucous  membranes,  on  that  of  the  urethra,  for  example, 
we  see  enormous  quantities  of  pus  secreted,  as  in  gonorrhoea, 
without  even  the  slightest  ulceration  being  present  on  the 
surface.  This  depends  essentially  upon  the  presence  of  several 
strata  of  cells,  the  upper  forming  a  kind  of  protection  to  the 
deeper  ones,  of  which  the  proliferation  is  thus  for  a  time 
secured.  The  pus  is  at  last  either  borne  away  by  the  production 
of  new  masses  of  pus  beneath  it,  or  there  occurs  simultaneously 
a  transudation  of  fluid,  which  removes  the  pus  cells  from  the 
surface,  just  as  in  the  secretion  of  semen  the  epithelial  elements 
of  the  seminal  tubes  furnish  the  spermatozoa,  and,  in  addition, 
a  fluid  which  sweeps  them  away.  But  the  spermatozoa  do  not 
arise  in  this  fluid ;  this  is  only  the  vehicle  for  their  onward 
movement.  In  this  manner  we  frequently  see  fluid  exude  on 
the  surface  of  the  body  without  our  being  able  to  regard  it  as 
a  cystoblastema.  If  a  proliferation  of  epithelium  simultaneously 
takes  place  upon  the  surface,  the  elements  detached  by  the 
transuded  fluid  will  also  be  found  to  consist  of  nothing  but 
proliferating  epitlielium." 


COMPARISON  BETWEEN  MUCUS,  EPITHELIUM,  AND  PUS. 

If  now  pus,  mucus,  and  epithelial  cells  be  compared  with  one 
another,  it  appears  that  there  certainly  does  exist  a  series  of 
transitional  forms  or  intermediate  stages  between  pus  corpuscles 
and  the  ordinary  epithelial  structures.  By  the  side  of  perfectly 
formed  pus  corpuscles  provided  with  several  nuclei  are  very  com- 
monly found  somewhat  larger,  round,  granular  cells  with  single 


40  TERMINATIONS  OF  INFLAMMATION. 

nuclei,  the  so-called  mucus  corpuscle.  A  little  further  ou  we  see 
perhaps  still  larger  cells  of  a  typical  form,  and  with  single  large 
nuclei,  and  these  we  call  epithelial  cells.  But  the  epithelial  cells 
are  flat,  angular,  or  cylindrical ;  whilst  mucus  and  pus  corpuscles, 
under  all  circumstances,  remain  round.  Even  from  this  circum- 
stance may  be  derived  an  explanation  of  the  fact  that,  whilst 
the  epithelial  cells  wliich  cover  and  are  in  close  opposition  to 
one  another,  acquire  a  certain  firmness  of  cohesion,  mucus  and 
pus  corpuscles,  which  lie  but  loosely  one  against  the  other,  and 
are  of  a  spherical  shape,  retain  a  great  degree  of  mobility, 
and  are  easily  displaced.  It  has  been  said  that  mucus  cor- 
puscles are  nothing  more  than  young  epithelium.  Another 
step,  and  pus  corpuscles  would  be  nothing  more  than  young 
mucus  corpuscles.  This  is  a  somewhat  erroneous  notion.  It 
cannot  be  maintained  that  a  cell  which,  up  to  the  point  when 
it  becomes  a  so-called  mucus  corpuscle  has  preserved  its  form 
as  a  spherical  body,  is  still  in  a  condition  to  assume  the  typical 
form  of  the  epithelium,  which  ought  to  exist  in  the  part ;  and 
just  as  little  can  it  be  said  that  a  pus  corpuscle,  after  it  has 
developed  itself  in  the  regular  manner,  is  capable  of  again 
entering  upon  a  course  of  development  calculated  to  produce 
a  relatively  permanent  element  of  the  body.  The  cells  in  which 
the  development  of  epithelial,  mucus,  and  pus  cells  originate 
are  young  forms,  but  they  are  not  pus  corpuscles.  In  pus, 
every  new  cell  at  a  very  early  period  sets  about  dividing  its 
nucleus.  After  a  short  time  the  division  of  the  nucleus  reaches 
a  high  pitch  without  any  further  growth  on  the  part  of  the 
cell.  In  mucus,  the  cells  are  wont  merely  to  grow,  and  in 
some  instances  to  become  very  large;  but  they  do  not  pass 
certain  limits,  and,  above  all,  they  do  not  assume  any  typical 
form.  In  epithelium,  on  the  contrary,  the  elements  begin 
even  at  a  very  early  period  to  assume  their  peculiar  form; 
for  "  what  is  to  become  a  hook  right  early  gets  a  crook."  The 
very  youngest  elements,  however,  which  are  found  in  pathological 
conditions,  cannot  be  called  epithelial  cells,  or  at  least  they  have 
as  yet  nothing  typical  about  them,  but  are  indifferent  formative 
cells  which  might  also  become  mucus  or  pus  corpuscles. 

Pus,  mucus,  and  epithelial  cells  are  therefore  pathologically 
equivalent  parts,  which  may  indeed  replace  one  another,  but 
cannot  perform  each  other's  functions. 


COMPARISON  BETWEEN  MUCUS,  EPITHELIUIM,  AND  PUS.         41 

Observations  and  experiments  made  known  since  the  publi- 
cation of  the  first  edition  of  this  work  compel  me  to  modify 
the  view  I  then  expressed,  that  the  formation  of  pus  was  not 
due  to  wandering  leucocytes;  for  Cohnheim,  Von  Reckling- 
hausen, Strieker,  Sanderson,  and  others  have  demonstrated  more 
or  less  clearly  that  pus  corpuscles,  at  the  commencement  of  every 
acute  inflammation,  may  be  derived  from  the  blood — i.e.,  that 
they  may  be  emigrant  white  corpuscles  which  have  escaped 
through  the  walls  of  the  capillaries.  But  even  Cohnheim 
sees  that  there  is  nothing  in  the  facts  which  contradicts  the 
previously  accepted  belief,  supported  as  it  is  by  an  over- 
whelming mass  of  evidence,  that  the  later  generations  are  the 
offspring  of  the  inflamed  tissues  by  proliferation  of  their  cell 
elements. 

The  experiments  which  most  strongly  demonstrate  that  the 
white  corpuscles  have  the  power  of  locating  themselves  in 
inflamed  tissues,  in  virtue  of  their  own  inherent  power  of  move- 
ment, are  as  follows.  Strieker  irritated  one  eye  of  a  frog  by 
cauterizing  the  cornea  through,  then  excised  the  cornea  of  the 
opposite  eye,  and  inserted  it  beneath  the  membrana  nictitans  of 
the  irritated  eye,  and  finally  united  the  edge  of  that  membrane 
with  the  opposite  margin  of  the  cutis  by  ligatures.  After 
twenty-four  hours  the  transplanted  cornea  was  removed  and 
examined,  and  found  to  exhibit  inflammatory  changes,  which, 
although  on  the  whole  less  advanced  than  those  found  in  an 
unexcised  cornea  at  the  same  period  after  irritation,  were  equally 
characteristic. 

These  results  scarcely  admit  of  misrepresentation;  they  are, 
however,  rendered  much  more  decisive  and  satisfactory  by  vary- 
ing the  conditions  of  the  experiments  in  such  a  way  as  to  show 
that  the  changes  observed  are  not  due  to  the  penetration  of 
leucocytes  from  the  liquid  in  which  the  cornea  is  immersed, 
and  secondly,  that  they  are  not  a  mere  result  of  its  traiisplanta- 
tion  into  an  unnatural  position.  The  first  of  these  objects  is 
readily  attained  by  dividing  the  cornea  immediately  after 
excision,  plunging  one-half  in  water  so  as  to  kill  it  instantly, 
and  then  placing  the  dead  and  the  living  portion  together 
underneath  the  membrana  nictitans  of  the  opposite  eye.  It  is 
then  found  that  whereas  the  same  inflammatory  changes  as  be- 
fore go  on  in  the  living  half,  the  other  half  remains  inactive. 


42  TERMINATIONS  OF  INFLAMMATION. 

The  second  result  is  attained  by  the  observation  of  what 
happens  when,  instead  of  first  cauterizing  the  eye  which  is 
destined  to  be  the  recipient  of  the  transplanted  cornea,  it 
is  left  uninjured.  At  the  end  of  twenty-four  hours  the  cor- 
puscles of  the  transplanted  cornea  are  found  quite  unaltered, 
and  so  distinct  that  the  plan  is  strongly  recommended  as  a 
method  of  demonstrating  their  normal  character. — (Klein, 
Sanderson.) 

These  varied  results  seem  therefore  to  show,  beyond  the  pos- 
sibility of  dispute,  that  the  structural  changes  in  the  cornea  of 
tlie  frog  cannot  be  dependent  either  upon  any  influence  ex- 
ercised by  the  nervous  system,  or  by  transmission  of  the  irrita- 
tive effects  from  one  structural  element  to  another,  so  that  we 
have  good  ground  for  concluding  with  Professor  Strieker  that 
they  result  exclusively  from  the  stimulating  influence  of  the 
exuded  liquid.  The  precise  physical  or  chemical  conditions  are 
as  yet  unknown,  and  are  at  the  present  moment  subjects  of  further 
investigation.  Whilst  these  experiments  prove  that  the  forma- 
tion of  pus  is  sometimes  due  to  the  power  of  the  white  corpuscles 
of  penetrating  living  tissue,  they  do  not  destroy  the  facts  that 
the  formation  of  pus  may  be  independent  of  their  presence.  In 
the  case  of  pus  formation  in  cartilage — where  the  cartilage  cells 
are  isolated  in  cavities  in  the  matrix,  having  no  communication 
with  each  other,  but  entirely  closed — it  is  seen  when  the  surface 
of  the  cartilage  is  irritated,  that  the  cells  in  the  neighbourhood 
of  the  irritation  enlarge,  and  expand  their  capsules.  The  pro- 
toplasm of  which  each  cell  consists  becomes  more  granular,  and 
soon  contains  two  corpuscles  in  its  interior  instead  of  one,  and 
has  a  gathering  of  protoplasmic  matter  around  itself.  This 
process  of  division  is  repeated  in  each  segment  until  every 
cavity  contains  a  mass  of  nucleated  cells,  which  at  length  as- 
sume characters  corresponding  with  those  of  newly  formed  pus 
corpuscles,  while  at  the  same  time  the  original  interstitial  sub- 
stance gradually  wastes  away  and  is  finally  represented  by  a 
sponge-like  stroma,  in  the  holes  of  which  groups  of  young  cells 
are  contained. 

In  this  process  we  have  a  typical  example  of  germination ; 
the  permanent  cells  which  have  for  their  function  the  main- 
tenance of  the  unchanging  life  of  the  tissue,  are  replaced  by  a 
more  numerous  progeny  of  transitory  mobile  cells,  which  live 


STRANGLES.  43 

at  the  expense  of  what  remains  of  the  tissue,  and  eventually 
destroy  it. 

FEBRA  PYOGENICA,  OR  STRANGLES. 

As  an  example  of  suppurative  disease,  associated  with  a 
varying  degree  of  febrile  disturbance,  we  have  in  the  horse  what 
from  time  immemorial  has  been  termed  StrauG^les.  The  oriojin 
of  the  term  strangles  arises  from  the  fact  that  in  some  cases 
it  is  associated  with  symptoms  of  choking  or  strangulation, 
and  it  w^as  divided  by  the  old  writers  into  simple  and  bastard 
strangles;  the  first  form  being  that  which  ran  a  regular  course, 
and  the  second  consisting  in  the  formation  of  multiple  or  suc- 
cessive abscesses. 

Simple  strangles  may  be  defined  to  be  a  febrile  disease, 
generally  attacking  young  horses,  and  terminating  in  the 
ibrmation  of  an  abscess  or  abscesses  in  the  areolar  tissue  of 
the  submaxillary  space. 

Irregular  or  bastard  strangles,  on  the  other  hand,  is  a  very 
grave  affection,  in  which  the  connective  tissue  of  the  lympha- 
tics of  the  submaxillary  region,  and  sometimes  the  salivary 
glands,  are  the  seat  of  acute  suppurative  inflammation,  asso- 
ciated with  a  low  febrile  state  of  the  system,  a  tendency  to 
suppurative  action  in  various  parts  of  the  animal  body,  more 
especially  in  the  mesenteric,  bronchial,  axillary,  and  inguinal 
glands,  and  to  purulent  infiltrations  in  the  parenchyma  of 
organs  or  into  the  subcutaneous  areolar  tissue. 

It  is  thought  by  some  that  strangles  is  contagious,  from  the 
circumstance  that  when  one  case  occurs  in  a  stud  others  very 
often  soon  follow.  This,  however,  is  not  sufficient  proof  of  its 
being  contagious.  It  is  a  debateable  point  whether  strangles 
is  contagious  or  not.  Many  proofs  can  be  brought  forward  in 
support  of  either  view,  some  observers  stating  tliat  they  have 
induced  it  in  inoculation — Gohier,  Eeynal,  Toggia.  In  some 
instances — like  typhoid  fever  of  man — it  seems  contagious  to 
some  extent,  while  in  others  it  shows  no  tendency  to  spread 
by  this  mode.  My  own  experience  leads  me  to  conclude  that 
it  is  a  non-contagious  disease,  but  whilst  tliere  is  still  any  doubt 
about  the  matter,  it  is  better  to  take  precautions  against  its 
diffusion  by  separating  the  affected  from  the  healthy. 

Although  it  is  generally  found  to  attack  young  horses,  it  is 


44  TERMINATIONS  OF  INFLAMMATION. 

by  no  means  ■uncommon  to  find  aged  animals  take  the  disease. 
In  some  localities,  and  during  some  years,  it  assumes  the  form 
of  an  enzootic,  attacking  animals  of  all  ages. 

It  is  an  unsettled  question  whether  horses  take  strangles 
more  than  once  in  their  lives,  and  the  point  is  not  easily  solved, 
as  the  history  of  animals  is  hard  to  trace.  I  think  it  may  be 
laid  down  as  a  rule  that  it  rarely  attacks  the  same  horse  more 
than  once,  after  which  the  predisposition  to  it  disappears. 

The  causes  of  strangles  are  very  obscure.  It  is  thought 
that  dentition  has  something  to  do  with  it ;  and  this  may  be 
accepted  as  a  tangible  reason,  as  the  majority  of  cases  occur 
during  the  active  period  of  dentition.  But  it  by  no  means 
follows  that  this  is  the  only  predisposing  cause,  for  animals  with 
full  mouths  are  very  often  attacked  with  strangles.  Domesti- 
cation has  also  been  looked  upon  as  the  cause  of  strangles ;  but 
this  cannot  be,  otherwise  animals  that  have  never  been  stabled 
would  not  suffer,  whereas  horses  at  grass  very  often  have  it. 

Horses  from  a  few  months  to  six  years  old  are  the  common 
subjects  of  strangles.     When  they  are  very  young,  the  disease 
generally  assumes  a  virulent  form,  and  often  proves  fatal,  either 
from  internal  abscesses,  purulent  infiltrations,  or  a  condition  ^ 
similar  to  the  hectic  fever  of  human  beincjs. 

Symptoms. — Strangles  manifests  itself  in  three  ways. 

1st.  It  commences  with  the  common  symptoms  of  a  mild 
catarrhal  affection.  The  animal  is  somewhat  dull,  has  a  slight 
cough,  some  soreness  of  throat,  a  disinclination  to  feed,  and 
more  or  less  inability  to  swallow.  The  submaxillary  space 
swells,  is  hot  and  tender,  the  swelling  filling  up  the  whole 
space  or  confined  to  one  side  only ;  and  is  either  diffused  or 
circumscribed.  There  is  generally  some  dribbling  of  saliva  from 
the  mouth,  and  a  discharge  from  the  nostrils.  In  most  instances 
the  pulse  is  somewhat  hurried,  and  the  respiratory  movements 
slightly  increased. 

2d.  For  some  weeks,  or  even  months,  prior  to  the  local 
manifestation  of  the  disease,  the  animal  is  unthrifty,  loses  flesh, 
becomes  hide-bound,  drawn  up  at  the  flank ;  if  at  grass,  stands 
apart  from  his  fellows,  has  more  or  less  cough,  often  stretches 
himself  as  if  fatigued,  shivers  on  the  application  of  slight  cold, 
his  coat  stares,  his  growth  is  arrested.  The  horseman  says  that 
"  he  is  breeding  strangles,"  and  time  confirms  the  correctneSvS 


STRANGLES.  45 

of  this  opinion,  the  local  signs  of  the  disease  becoming  developed, 
and  very  often  to  a  more  severe  extent  than  in  the  first  form. 

od.  The  premonitory  signs  are  those  which  have  given  tlie 
name  to  the  disease,  namely,  those  simulating  strangulation,  with 
great  difficulty  of  respiration,  accompanied  by  a  loud  trumpet- 
like sound,  emitted  more  especially  during  inspiration.  This 
sound  may  arise  from  spasm  of  the  muscles  that  close  the 
glottis,  namely,  the  crico-thyroideus,  crico-arytenoideus  lateralis, 
thyro-arytenoideus,  &c.  ;  or  from  an  cedematous  condition  of  it 
(oedema  glottidis).  If  from  the  first  cause,  the  inspiratory  sound 
only  is  heard;  but  if  from  the  second,  both  movements  may 
be  accompanied  by  the  roaring  noise,  the  inspiratory  to  a  greater 
extent  than  the  expiratory. 

The  treatment  of  regular  strangles  is  very  simple,  and  con- 
sists of  fomentations  and  poultices  to  the  part,  to  promote  the 
growth  of  the  pus ;  slight  febrifuge  medicines,  as  the  nitrate  of 
potash,  to  modify  any  accompanying  fever ;  keeping  the  bowels 
in  order  by  laxative  diet  or  very  mild  aperients,  as  oil,  or  the 
sulphate  of  magnesia.  If  the  tumour  points  and  bursts  spon- 
taneously, it  is  advisable  not  to  interfere  with  its  course,  either 
by  incision  or  external  irritants;  but  if  it  is  indolent,  "  seeming 
to  hang  fire,"  as  it  were,  it  is  good  practice  to  ajjply  a  blister. 
Some  writers  and  teachers  condemn  this  plan  of  treatment.  I 
feel  quite  sure  that  such  are  men  of  no  experience,  a  blister 
often  acting  like  magic  in  promoting  the  suppurative  action  in 
the  tumour,  or  in  dispersing  it  altogether  without  suppuration. 
The  best  plan  is  to  apply  a  good  fiy  blister,  and  a  warm  poul- 
tice in  about  twenty-four  hours  afterwards.  When  the  abscess 
has  burst,  all  that  is  necessary  is  to  keep  it  clean,  and  to  give 
the  animal  good  food,  with  tonics,  the  preparations  of  iron  being 
the  best.  After  apparent  recovery  from  strangles,  care  must 
be  taken  not  to  expose  the  animal  to  any  debilitating  influence, 
as  work  or  cold,  too  soon,  for  secondary  abscesses  may  form  in 
the  internal  organs. 

The  second  form  of  strangles— namely,  that  ushered  in  by  a 
lengthened  period  of  unthriftiness — must  be  treated  locally,  in 
the  same  manner  as  the  first  form;  but  the  constitution  will 
require  to  be  supported  by  good  food  and  tonics  before  there 
are  any  local  manifestations.  If  the  animal  is  at  grass,  it  must 
be  taken  up  and  protected  from  the  vicissitudes  of  the  weather 


46  TERMINATIONS  OF  INFLAMMATION. 

by  being  lodged  in  a  roomy,  airy  place ;  must  have  an  allow- 
ance of  corn — crushed  oats  in  preference;  and  be  regularly 
fed  and  carefully  watched,  as  the  most  severe  forms  of  the 
disease,  namely,  those  associated  with  internal  abscesses,  are 
ushered  in  by  the  above  premonitory  signs.  If  the  tumours 
suppurate  kindly,  and  the  disease  runs  its  course  regularly,  the 
animal  will  soon  regain  its  former  condition,  will,  in  fact,  thrive 
better  than  ever,  and  will  seem  as  if  the  system  had  been  rid  of 
some  deleterious  material. 

In  the  third  form,  great  watchfulness  must  be  used  for  fear 
that  the  patient  dies  of  suffocation.  To  prevent  this  the  opera- 
tion of  tracheotomy  may  have  to  be  performed. 

As  to  the  necessity  of  this  operation,  and  the  time  for  its 
performance,  there  is  a  difference  of  opinion.  Some  think  it 
ought  to  be  performed  early,  to  enable  the  glottis  to  remain  in 
a  state  of  repose,  and  thus  recover  more  speedily  than  if  kept 
in  activity  by  the  respiratory  movements;  while  others  con- 
demn the  operation  except  as  a  dernier  resort.  Of  the  two 
opinions  the  former  is  the  more  humane  and  rational,  but  the 
latter  is  supported  by  a  more  extensive  experience.  Without 
discussing  the  point,  I  may  state  that  my  own  practice  con- 
sists in  hot  fomentations  to  the  throat,  succeeded  by  a  mustard 
liniment,  making  the  animal  inhale  watery  vapour  for  some 
hours  and  watching  the  case  carefully.  If  the  dyspnoea  in- 
crease, I  perform  tracheotomy ;  but  if  it  decrease  even  slightly, 
I  go  on  with  the  steaming  and  fomentations.  There  is  a  diffi- 
culty in  applying  poultices  to  the  throat,  and  I  find  a  good 
substitute  in  woollen  waste  confined  to  the  parts  within  the 
hood.  A  poultice  soon  gets  cold,  and  is  apt  to  do  more  harm 
tlian  good  if  not  carefully  applied  and  continually  watched.  Hot 
fomentations  and  packing  with  wool  are  therefore  preferable. 

In  performing  tracheotomy,  the  best  plan  is  to  elevate  the 
horse's  head,  extend  the  nose,  so  as  to  draw  the  inferior  cervical 
muscles  into  a  state  of  tension,  then  to  feel  along  the  course  of 
the  trachea  for  the  part  least  covered  with  muscular  and  adi- 
pose tissue,  and  to  make  a  bold  incision  through  the  skin 
and  subcutaneous  structures  on  to  the  trachea.  The  incision 
must  be  about  four  inches  long,  exposing  the  trachea  clearly  to 
view.  When  this  is  done,  introduce  the  point  of  a  sharp-pointed 
bistoury  into   the  trachea,  between  the  upper  exposed  rings, 


STRANGLES.  47 

divide  two  or  three  clearly  across,  and  introduce  the  tube,  taking 
care  in  doing  so  that  the  divided  rings  are  not  pressed  into  the 
trachea. 

The  tracheotomy  tube  must  be  tied  around  the  animal's  neck 
and  to  the  mane,  in  order  to  keep  it  steadily  in  position. 

There  is  no  need  for  casting  the  horse  for  this  operation ;  if 
it  be  quickly  done,  there  is  scarcely  a  necessity  for  the  twitch, 
as  the  poor  animal  is  too  ill  to  be  very  unruly.  The  tube 
should  be  kept  in  until  it  is  manifest  that  the  animal  is  able 
to  breathe  freely  through  the  nostrils.  This  is  ascertained  by 
putting  the  hand  over  the  tube  for  a  few  minutes,  when,  if  the 
patient  breathes  naturally  and  without  distress,  it  may  be  re- 
moved, and  the  lips  of  the  wound  brought  together  by  metallic 
sutures. 

In  a  period  varying  from  a  day  to  a  week  after  the  first  symp- 
toms, the  local  manifestations  of  strangles  are  developed,  and 
until  these  are  apparent,  the  disease  is  classified  as  laryngitis. 

The  local  lesions  are  generally  much  more  severe  than  in 
the  first  or  even  second  form.  The  tumours  are  multiple,  or 
diffused  over  the  sides  of  the  face,  nostrils,  submaxillary  space, 
and  parotidean  region;  suppurating  at  several  points,  and  dis- 
charging an  unhealthy  pus.  Horses  confined  in  ill-ventilated 
stables  suffer  most  commonly  from  this  form,  and  if  not  removed 
to  a  healthier  situation,  it  is  apt  to  degenerate  into  a  hectic  con- 
dition, succeeded  by  pyaemia,  or  to  terminate  in  glanders. 

The  hectic  condition  is  that  in  which  the  animal  continues 
to  lose  flesh  very  rapidly,  to  have  a  discharge  from  one  or 
both  nostrils  of  a  tenacious  muco-purulent  material.  Abscesses 
continue  to  be  formed  one  after  another  on  the  face  and.  the 
submaxillary  space ;  the  patient  becomes  hide-bound,  with  a  dry, 
scurfy  skin,  and  drawn  up  in  the  flank.  The  hair  of  the  mane 
and  the  tail  is  easily  pulled  out ;  the  pulse  is  soft,  compressible, 
feeble,  and  quick ;  the  legs,  at  first  fine,  begin  to  swell,  and  the 
various  serous  cavities  fill  with  serum,  the  patient  becoming 
affected  with  glanders  and  farcy,  or  it  may  die  of  exhaustion, 
diarrhoea,  excessive  secretion  of  urine,  loaded  with  hippurates 
and  oxalates,  or  of  dropsy  of  the  serous  cavities. 

The  treatment  of  this  condition  consists  first  in  the  removal 
of  the  horse  from  an  unhealthy  to  a  healthy  situation.  He 
should  be  kept  in  a  box  by  himself,  and  have,  in  addition  to 


48  TEKMINATIONS  OF  INFLAMMATION. 

a  liberal  allowance  of  corn,  liay,  or  grass,  a  gallon  of  new  milk 
during  the  day ;  he  will  soon  become  fond  of  it.  He  should 
be  made  to  drink  it  instead  of  water,  and  if  kept  without  the 
latter  for  a  few  hours,  will  drink  the  milk  with  avidity.  If  the 
appetite  is  entirely  lost,  six  eggs  ought  to  be  beaten  up  and 
mixed  with  each  gallon  of  milk. 

The  strength  must  also  be  kept  up  with  tonics,  iron,  quinine, 
wine,  or  beer,  and  acids  ;  and  should  these  fail,  nux  vomica  and 
arsenic  in  small  doses. 

I  have  seen  many  cases  of  this  kind  of  mal-condition,  which 
I  have  ventured  to  compare  to  the  hectic  fever  of  the  human 
being,  rapidly  recover,  with  very  little  treatment,  after  being 
removed  from  a  crowded  stable  to  a  airy,  loose  box. 

Pyaemia  differs  from  the  latter  condition  by  the  development 
of  abscesses,  or  of  purulent  infiltrations  in  various  internal 
organs,  and  from  irregular  strangles  by  the  abscesses  being 
secondary  to,  and  not  concomitant  with,  those  in  the  sub- 
maxillary space.  In  reality  there  is  but  little  difference, 
except  that  in  the  one  case  the  internal  collections  of  pus 
are  due  to  a  diathesis,  and  in  the  other  to  the  absorption  of 
some  deleterious  material  generated  in  the  pus  of  the  primary 
abscess. 

Mr.  Haycock  was,  I  think,  the  first  to  point  out  the  occur- 
rence of  pyaemia  succeeding  strangles  (see  his  Contribution  to 
Veterinary  Patlwlogy,  1849-50),  under  the  term  "  Phlebitis." 
Since  then  the  subject  has  received  considerable  attention,  but 
even  to  this  day  cases  are  described  as  pysemia  which  are  in 
reality  extensive  abscesses,  infiltrations,  excessive  suppurations, 
or  farcy. 

PytTemia  may  be  defined  to  be  a  typhoid  condition,  accom- 
panied by  multiple  abscesses  or  purulent  infiltrations  into  one 
or  more  organs,  resulting  generally  from  strangles,  parturition, 
and  from  injury  or  surgical  operation. 

Four  theories  have  been  promulgated  with  the  view  of  ex- 
plaining the  pathognomy  of  pyaemia: — 

1st.  "  Tiiat  this  condition  is  owing  to  an  admixture  of  the 
blood  with  pus  (pyohemia  of  Piorry),  and  that  the  pus  corpuscles 
being  larger  than  the  coloured  ones  of  blood,  are  arrested  in 
the  minute  capillaries,  and  give  rise  to  secondary  abscesses. 
2d.  That  it  is  owing  to  the  presence  of  some  irritant  body, 


PYAEMIA.  4*9 

which,  not  being  able  to  escape  from  the  economy,  produces 
capillary  phlebitis,  od.  That  it  is  dependent  on  a  property 
possessed  by  pus  of  coaguLating  the  blood.  4:tJi.  That  it  is 
caused  by  the  presence  of  a  peculiar  poison,  which  contaminates 
the  system." — (Bennett.) 

The  first  theory  is  founded  upon  the  assumption  that  pus  cells 
differ  from  the  white  globules  of  the  blood ;  whereas  in  reality  no 
actual  difference,  either  in  size,  structure,  or  behaviour,  on  the 
addition  of  re-agents  can  be  detected  ;  therefore,  if  the  capillaries 
are  sufficiently  large  to  admit  the  passage  of  the  white  blood 
globule,  they  must  consequently  be  large  enough  to  admit  the 
passage  of  the  pus  cell. 

The  second  explanation  was  advanced  by  Cruveilhier,  who, 
on  injecting  mercury,  ink,  and  other  substances  into  the  blood 
of  a  living  animal,  found  that  abscesses  were  formed  wherever 
these  accumulated ;  hence  it  seemed  to  follow  that  the  impaction 
of  certain  substances  in  the  tissues  may  induce  local  inflamma- 
tions, and  lead  to  abscesses ;  but  that  such  is  not  the  necessary 
result  of  admixture  of  pus  with  the  blood  is  proved  not  only 
by  the  previous  observations,  but  by  numerous  experiments  of 
Lebert  and  Sedillot,  in  which  the  animals  recovered. 

The  third  doctrine  was  advanced  by  Mr.  Henry  Lee,  and 
resulted  from  observing  that  when  pus  was  mingled  with 
recently  drawn  blood,  it  coagulated  more  rapidly  and  more 
firmly  than  under  ordinary  circumstances. 

But  although  this  may  be  true  as  regards  pus  when  mixed 
with  recently  drawn  blood,  it  does  not  follow  that  it  induces 
coagulation  of  living  blood  in ^ the  vessels  of  an  animal;  and 
numerous  experiments  by  Lebert,  Sedillot,  Bennett,  and  the 
late  Professor  Barlow,  show  that  such  does  not  take  place :  in 
some  cases  death  followed,  in  others  the  animals  lived,  and  the 
pus  corpuscles  were  dissolved. 

The  fourth  theory  is  based  upon  the  opinion  that  good  pus  is 
innocuous,  and  that  the  bad  effects  occasionally  produced  depend 
on  its  becoming  putrid,  or  being  otherwise  altered.  It  is  now 
generally  believed  that  pyaemia  is  due  to  a  poisonous  principle 
associated  with  the  pus  ;  hence  it  is  proposed  to  substitute  the 
terms  ichorsemia  (ViRCiiow),  or  septicaemia  (Vogel),  for  pyaemia. 

The  signs  of  pyaemia  may  not  manifest  themselves  for  some 
time  after  the  primary  abscess  has  discharged  itself;  never  iu 

£ 


"50  TERMINATIONS  OF  INFLAMMATION. 

my  experience  before  the  pus  has  come  into  contact  with  tlie 
atmosphere,  and  they  will  depend  upon  the  seat  of  the  second- 
ary purulent  collections.  In  the  human  patient  the  symptoms 
are  very  characteristic ;  in  addition  to  others,  the  breath  has  a 
smell  of  new-made  hay,  and  the  skin,  especially  by  the  side  of 
the  nose,  and  about  the  eyebrows,  becomes  yellow ;  but  in  the 
horse  these  are  not  recognisable.  In  one  case  of  purulent 
infiltration  into  the  lungs  succeeding  strangles,  I  did  think 
that  the  smell  of  new  hay  was  present ;  but  it  was  soon 
succeeded  by  a  most  offensive  odour  of  decomposing  animal 
matter.  I  think  the  most  prominent  and  characteristic  sign 
is  a  total  loss  of  appetite,  or  an  apparent  loathing  of  food, 
associated  with  occasional  colicky  pains  when  the  abscesses  are 
in  the  mesentery;  with  symptoms  of  pneumonia  and  foetid 
breath  when  in  the  lungs,  and  yellowness  of  the  mucous  mem- 
branes when  in  the  liver.  The  animal's  head  is  held  low  and 
drooping,  the  countenance  is  sunken  and  cadaverous  looking, 
and  the  body  generally  emaciated. 

Haycock  describes  it  as  phlebitis,  and  it  appears  that  in  his 
case  inflammation  of  the  veins  was  present ;  but  it  by  no  means 
follows  that  this  is  always  the  case.  I  have  made  careful  ex- 
aminations of  several,  and  found  this  condition  sometimes  pre- 
sent, sometimes  absent. 

As  regards  treatment,  I  know  of  none  that  can  arrest  the 
progress  of  the  disease  when  it  has  set  in ;  all  that  can  be  done 
is  to  be  careful  that  the  surroundings  of  a  case  of  strangles  are 
healthy,  specially  avoiding  bad  drainage  and  bad  ventilation. 
"When  I  was  in  practice  at  Bradford,  in  Yorkshire,  nearly  every 
case  of  strangles  which  occurred  near  the  Bradford  Beck  (brook 
or  rivulet)  and  Canal  proved  fatal,  pyemia  supervening ;  this 
fatal  result  could  only  be  accounted  for  by  the  putridity  of  the 
water,  both  in  the  canal  and  the  beck,  and  by  the  exhalations 
from  them  having  found  their  way  into  the  stables  in  their 
neighbourhood,  and  set  up  a  septic  fermentation  in  the  pus 
when  exposed  to  their  contaminating  influence. 

If  the  secondary  abscesses  form  near  the  surface  of  the  body, 
as  in  the  groin  or  subscapular  region,  they  must  be  opened, 
and  in  all  cases  the  animal  must  be  supported  with  tonics, 
good  food,  milk,  eggs,  wine,  beer,  quinine,  and  small  doses  of 
the  chlorate   of  potash;   but   should   the   lymphatics   become 


PYiEMIA.  51 

corded,  and  abscesses  form  in  the  glands  along  their  course, 
the  disease  will  have  degenerated  into  farcy,  and  may  ulti- 
mately terminate  in  glanders. 

RE-ABSORPTIOX  OF  PUS. 

It  was  imagined  at  one  time  that  pus  might  again  be  taken 
up  from  the  different  points  at  which  it  had  been  formed,  and 
tliat  a  favourable  turn  was  thereby  effected  in  a  suppurative 
disease ;  but  pus,  as  pus,  is  not  absorbed ;  and  it  is  always 
its  fluid  part  (liquor  puris)  which  is  taken  up,  and  as  this  dis- 
appears the  pus  becomes  thicker,  constituting  what  is  termed 
inspissated  pus,  which  contains  the  pus  cells  in  a  shrivelled 
condition.  Not  only  is  the  serum  in  which  the  cells  float  ab- 
sorbed, but  also  that  contained  within  them ;  and  in  proportion 
as  this  is  the  case,  the  cells  become  smaller,  more  irregular, 
more  angular,  more  uneven ;  they  assume  the  most  singular 
forms,  lie  closely  pressed  together,  forming  tlie  cheesy  concre- 
tions which  have  been  confounded  with  tubercle. 

There  is  anotlier  method  by  which  pus  is  removed, — that  is, 
by  fatty  degeneration  of  the  pus  cells.  Every  cell  sets  fatty 
particles  free  within  it — breaks  up ;  and  at  last  nothing  remains 
but  fat  granules  and  intervening  fluid  of  a  milky  appearance, 
and  constituting  what  is  termed  pathological  milk,  which  is 
absorbed:  here,  again,  pus  is  not  re-absorbed  as  pus,  but  as 
water,  fat,  and  salts. — (Virchow.) 

Inspissated  pus,  in  pieces  of  varying  size,  dry  and  hard,  is 
often  found  in  the  guttural  pouches  of  subjects  on  the  dissecting 
table ;  these  are  the  results  of  preceding  catarrhal  attacks  and 
formation  of  pus  in  thes^  cavities.  They  are  also  found  in  old 
abscesses,  and  give  rise  to  tumours  in  various  parts  of  the  body. 
— {See  TUMOUKS.) 

FORMATION  OF  SINUSES. 

When  pus  is  seated  in  parts,  the  action  of  which  is  defective 
owing  to  local  or  general  causes,  or  when  it  cannot  be  completely 
evacuated,  the  cavity  that  remains  does  not  contract  completely, 
and  the  wound  is  called  a  sinus  or  fistula. 

In  the  course  of  time  the  surface  of  the  sinus  becomes  smooth 
and  condensed,  so  as  to  resemble  mucous  membrane,  or  even 


52  TERMINATIONS  OF  INFLAMMATION. 

skin,  being,  in  old  confirmed  cases,  lined  with  a  downy  hair,  and 
so  thick  and  callous  tliat  its  walls  resemble  cartilaoje  in  their 
hardness.  This  hardening  of  the  walls  was  formerly  thought  to 
depend  upon  a  morbid  disposition  of  the  part,  and  to  require 
extirpation,  as  an  essential  step  to  the  animal's  recovery.  Tlie 
applications  and  operations  practised  for  this  purpose  were  ex- 
tremel}^  severe,  consisting  of  the  actual  cautery,  arsenic,  corrosive 
sublimate,  and  other  powerful  escharotics ;  but  a  more  enlightened 
patliology  has  led  to  their  disuse,  and  it  is  now  found  sufficient 
simply  to  remove  the  cause  of  the  irritation. 

"  In  treating  sinuses,  the  objects  are  to  promote  gTanulating 
action  on  their  surfaces,  and  to  press  their  sides  together.  They 
are  not  healed  \)j  filling  up,  any  more  than  the  original  cavity  of 
the  abscess,  but  contract  until  they  become  obliterated,  or  close 
more  directly  by  union  of  the  opposite  surfaces." — (Syme.) 

Great  care  must  be  taken  to  avoid  confining  the  discharge 
of  the  sinus,  since,  if  prevented  from  escaping,  it  distends  the 
sides  of  the  cavity,  and  for  the  same  reason  it  is  always  proper 
to  afford  the  matter  an  opening  for  its  complete  escape,  either 
by  enlarging  the  one  already  existing,  or  making  a  new  one. 
The  method  of  doing  this  will  be  explained  hereafter  in  connec- 
tion with  the  different  regions  in  which  sinuses  are  apt  to  be 
seated. 

ULCERATION. 

Ulceration  is  another  result  of  inflammation :  it  consists 
essentially  in  molecular  degeneration  of  a  part,  and  goes  on  by 
three  simultaneous  processes.  (1.)  An  exudation  of  inflamma- 
tory lymph  and  serum  surrounds  the  mass  of  young  cells,  Avhich 
constantly  continue  to  grow  on  the  surface,  and  at  the  margin 
of  the  ulcer,  causing  the  destruction  of  the  normal  textures. 
(2.)  Cells  are  thus  continually  growing  on  the  surface,  to  be 
carried  off  by  fresh  exudation.  (3.)  Liquefaction  of  the 
gelatinous  interstitial  material  supervenes,  and  so  destruction 
of  tissue  takes  place  continually. — (GooDSiii,  Aitken.) 

The  difference  between  ulceration  and  mortification  will  be 
described  hereafter,  but  I  may  here  state  that  I  cannot  conceive 
ulceiation  to  be  molecular  death  of  a  part,  but  rather  the  absorp- 
tion of  living  degenerate  textures,  by  which  gaps  or  solutions  of 
continuity  are  formed. 


ULCERATION.  53 


VARIETIES  AND  TREATMENT  OF  ULCERS. 

An  ulcer  is  defined  to  be  a  solution  of  continuity  caused  by 
ulceration,  and  its  varieties  in  Veterinary  Surgery  may  be 
arranged  under  six  heads.  1st.  Healthy  ulcer ;  2d.  Weak  ulcer ; 
3d.  Indolent  ulcer;  4:th.  Inflamed  ulcer;  5tli.  Gangrenous  or 
phagedenic,  or  sloughing  ulcer ;  and  6th.  Specific  ulcer. 

1st.  The  healthy  ulcer  is  smooth  at  its  edges,  which  are 
neither  everted  nor  inverted,  adherent  to  the  granulations,  and 
when  they  rise  to  a  level  with  the  skin,  a  film  or  cicatrix  is 
formed  like  a  semi-transparent  ring  round  the  edges,  and 
gradually  spreads  over  the  wound.  The  granulations  are  small, 
firm,  numerous,  and  of  a  fine  florid  colour,  pointed  at  their  tops, 
and  discharging  a  thick  laudable  pus. 

But  little  treatment  is  required  for  this  kind  of  ulcer,  beyond 
rest  and  cleanliness. 

2d.  The  weak  ulcer.  The  granulations  are  pale,  large,  flabby, 
not  pointed,  but  even  bulbous  at  their  tops,  less  vascular,  and 
less  apt  to  bleed  on  being  touched  than  those  of  the  healthy 
ulcer;  they  are  unattended  with  pain,  rise  above  the  level  of 
the  skin,  so  that  the  margins  of  the  ulcer  are  hid  from  view. 
The  discharge  is  thin,  pale,  and  watery. 

This  kind  of  ulcer  is  caused  by  some  debilitating  local  or 
general  influence.  It  is  often  found  in  the  hind  legs  of  low- 
bred animals,  and  arises  in  them  from  the  venous  congestion 
and  dropsical  effusion,  which  are  so  often  met  with  in  round- 
legged  cart  liorses.  It  is  associated  perhaps  with  some  con- 
stitutional weakness,  arising  from  bad  food,  or  other  cause  of 
general  debility.  Healthy  ulcers,  when  improperly  treated,  are 
aj)t  to  degenerate  to  this  form. 

The  treatment  ought  to  consist  of  some  mild  astringent 
dressing,  as  the  solution  of  sulphate  of  zinc  or  of  copper,  the 
periodical  use  of  the  nitrate  of  silver — say,  every  three  days,  if 
thought  requisite — and  the  careful  application  of  a  bandagei 
both  to  the  ulcer  and  to  its  neighbourhood,  in  order  to  stimulate 
the  granulations  and  to  correct  the  tendency  to  congestion. 
The  general  system  is  to  be  corrected  by  a  gentle  purgative, 
succeeded  by  tonics  and  diuretics ;  at  the  same  time  the 
strength  is  to  be  kept  up  by  good,  nourishing,  but  easily 
digestible  food,  dry  food  being  preferable-  to  moist.     The  patient 


&Se  TERMINATIONS  OF  INFLAMMATION. 

ought  to  have  regular  exercise,  and  great  attention  must  be  paid 
to  cleanliness. 

Sd.  Indolent  ulcer,  found  usually  about  the  coronet  of  old 
horses.  Its  edges  are  thick,  prominent,  comparatively  insensible, 
smootli,  shining,  firm,  incompressible,  and  without  any  appear- 
ance of  cicatrix ;  the  surrounding  parts  are  swollen,  hard,  in- 
compressible, and  if  the  skin  be  white,  discoloration  will  be 
seen  from  congestion  of  the  vessels;  the  surface  of  the  ulcer 
is  nearly  devoid  of  granulations,  smooth,  glossy,  and  whitish, 
grey,  or  brown  in  colour;  the  discharge  is  thin,  watery,  and 
scanty.  The  treatment  of  this  ulcer  is  by  blister,  succeeded  by 
gently  stimulating  dressings,  but  bandages  do  more  harm  than 
good.  The  constitutional  treatment  must  depend  upon  the 
condition  of  the  animal,  but  generally  a  purgative  is  useful. 

4:th.  Inflamed  ulcer.  The  edges  are  red  or  purple,  swollen, 
hot,  tense,  tender,  and  painful ;  the  sore  presents  no  granula 
lions,  but  has  a  raw,  pulpy,  foul,  and  even  livid  appearance; 
the  discharge  is  offensive,  profuse,  mingled  with  blood  and 
ulcerative  debris;  the  pain  is  great,  and  there  is  always  some 
attendant  fever.  This  ulcer  may  be  caused  by  the  presence  of 
some  foreign  body  in  the  part,  which  must  be  removed ;  it  may 
be  a  piece  of  dead  tissue,  skin,  ligament,  or  bone,  as  when  this 
ulcer  is  produced  by  a  tread.  Whatever  it  be,  the  first  step  in 
the  treatment  must  be  its  removal.  This  being  done,  the  in- 
flamed ulcer  must  be  converted  into  a  healthy  one  by  means 
calculated  to  subdue  excessive  irritability.  The  most  useful 
local  applications  for  this  purpose  are  warm  fomentations  and 
poultices,  combined  with  opiates ;  the  general  treatment  to  con- 
sist of  a  purgative,  succeeded  by  febrifuges,  and  the  diet  to  be 
light,  and  easy  of  digestion. 

5ih.  The  phagedenic,  gangrenous,  or  sloughing  ulcer,  which 
may  arise  from  constitutional  debility  or  from  local  causes,  as 
frost-bites,  is  that  in  which  the  edges  are  very  irregular,  and  of 
a  dark  purple  appearance,  extending  a  considerable  way  into  the 
surrounding  parts ;  they  are  often  inverted,  and  exceedingly 
painful.  The  surface  of  the  ulcer  is  uneven,  of  a  dark,  livid 
colour,  presenting  a  very  irritable  appearance  and  much  sur- 
rounding swelling.  The  discharge  is  thin,  ichorous,  and  mixed 
with  blood.  The  ulcer  enlarges  with  great  rapidity,  the  de- 
structive   process    being    carried    on  both   by   ulceration   and 


VARIETIES  AND  TREATMENT  OF  ULCERS.  55 

Bloughing.  In  some  cases  many  points  of  "ulceration  form  in 
the  neighbourhood  of  each  other,  the  ulceration  taking  place 
around  several  central  sloughs ;  these  by  enlargement  coalesce, 
and  ultimately  form  one  large  ulcer,  embracing,  as  in  some 
cases  of  "  carbuncle  of  the  coronary  band,"  a  space  of  several 
inches.  The  treatment  of  this  variety  is  a  matter  of  great 
urgency  and  importance,  but  not  always  satisfactory. 

Treatment. — Free  scarifications  of  the  part,  to  relieve  con- 
gestion ;  the  removal  of  all  sources  of  irritation,  and  the  appli- 
cation of  emollient  and  antiseptic  poultices  or  fomentations, 
constitute  the  best  local  treatment.  If  the  ulceration  continues 
to  spread,  I  have  seen  benefit  arise  from  the  gentle  application 
of  nitrate  of  silver  to  the  edges.  The  constitutional  derange- 
ment must  be  treated  by  purgatives,  anodynes,  or  sedatives, 
succeeded  by  tonics  ;  and  the  diet  regulated  according  to  the 
stage  and  variety  of  the  accompanying  symptoms. 

Specific  ulcers  will  be  described  with  the  diseases  of  which 
they  are  symptomatic. 


MORTIFICATION,  OR  DEATH  OF  A  PART. 

,  This  is  of  two  kinds,  complete  and  incomplete.  In  the  soft 
structures,  the  first  is  called  sphacelus,  and  the  second  gangrene ; 
whilst  mortification  of  the  blood  is  termed  necrgemia,  and  that 
of  the  hard  structures,  as  the  bones,  necrosis.  When  the  dead 
tissue  is  visible  to  the  naked  eye,  it  is  called  a  slough ;  when  it 
is  soft,  the  process  is  called  sloughing,  which  means  the  pro- 
gressive death  of  the  part  as  well  as  the  process  by  which  the 
slough  is  separated;  the  same  meaning  is  applied  to  exfoliation, 
or  the  process  of  separating  a  sequestrum  or  dead  piece  of  bone. 
But  so  long  as  the  dead  particles  of  tissue  ejected  in  the 
ulcerative  process  are  in  the  form  of  minute  particles,  visible 
only  with  the  microscope,  the  disease  is  spoken  of  as  ulceration, 
not  mortification  or  sloughing. 

Degeneration  of  a  part  may  be  distinguished  from  its  death 
by  the  fact  that  the  degenerated  part  never  putrifies,  and  that 
no  process  (sloughing)  ensues  for  its  separation  or  isolation,  such 
as  can  be  seen  in  the  case  of  a  dead  part.  "  However  degenerate 
a  tissue  may  be,  it  either  remains  in  continuity  with  those 
around  it,  or  it  is  absorbed.      If  the  samo  tissue  were  dead. 


56  TEKMINATIONS  OF  INFLAMMATION". 

those  around  it  would  separate  from  it,  and  it  would  be  ejected 
from  them." — (Paget.) 

Mortification  of  the  soft  parts  may  be  white  or  black  in 
appearance,  and  it  may  be  humid  (moist)  or  dry.  The  mortified 
part  has  a  black  appearance  when  the  blood  is  extravasated 
into  the  tissue,  giving  it  a  purple  or  dingy  hue,  whilst  to  the 
touch  it  is  soft  and  doughy.  It  has  a  dull-white  appearance  in 
frost-bites,  when  by  the  action  of  cold  the  blood  has  been 
driven  from  the  part. 

Moist  gangTcne  occurs  when  the  blood  transudes,  and  after 
its  transudation  separates  into  its  constituent  parts.  The  serum 
being  set  free,  dissolves  the  red  globules,  raises  up  the  surface 
of  the  cuticle  in  bladders,  forming  what  are  termed  "  phlyctense." 
Air  generated  by  incipient  putrefaction  is  not  unfrequently 
contained  in  the  phlyctente,  giving  to  the  finger  touching  the 
part  a  sensation  of  crepitation. 

Dry  mortification  is  very  rarely  met  with,  but  it  has  been 
observed  to  follow  the  use  of  ergotised  rye  as  food  on  tlie  Con- 
tinent of  Europe,  where  it  not  only  attacks  the  lower  animals, 
but  human  beings,  in  the  form  of  mortification  of  the  extremities. 
It  may,  however,  occur  in  any  part  of  the  body  which  has  been 
deprived  of  its  blood  and  a  further  supply  cut  off.  Sloughing 
of  the  cornea  has  been  observed  in  animals  fed  upon  food  defi- 
cient in  nitrogenous  elements,  and  in  my  experience  cases 
have  occurred  of  sloughing  of  the  tail  from  dry  gangrene  in 
horned  cattle  that  have  been  starved,  ill-treated,  or  have  suffered 
from  debilitating  diseases  or  old  age.  This  form  of  mortification 
may  also  be  observed  in  the  course  of  scarlatina  in  the  horse, 
"  when  some  extreme  part  of  the  organism,  such  as  the  ears, 
will  suddenly  present  a  blanched  appearance;  the  skin  of  these 
organs  wdll  suddenly  shrink  and  become  hard  and  dry,  as 
though  frozen,  and  in  the  course  of  a  day  or  two  these  blanched 
portions  snap  of,  leaving  exposed  a  raw  surface,  which  speedily 
suppurates."— (Haycock.)  Mortification  of  the  tails  of  mon- 
keys is  too  well  known  to  need  comment. 

Necr^mia,  or  death  of  the  blood,  is  well  shown  in  those  dire 
diseases  which  affect  horned  cattle,  namely,  splenic  apoplexy 
and  quarter-ill.  In  these  diseases  we  have  local  manifestations 
of  the  general  blood  crasis,  by  the  development  of  large  patches 
of  extravasation  of  dead  and  decomposing  blood,  the  death  and 


MORTIFICATION.  57 

decomposition  being  apparent  in  the  part  by  the  formation  or 
escape  of  tlie  gaseous  products  of  putrefaction  simultaneously 
with  the  appearance  of  the  extravasation,  giving  the  swellings 
a  feeling  of  crepitation  even  at  the  very  outset  of  tlie  disease. 

Mortiiication  may  arise  independently  of  the  inflammatory 
process  from  defective  quantity  of  blood  in  a  part.  This 
may  be  due  to  obstruction  of  its  artery  of  supply,  owing  to 
injury,  the  formation  of  a  clot  within,  or  pressure  constantly 
maintained  upon  it.  Portions  of  tissue  may  also  perish  when, 
by  injury  or  by  progressive  ulceration  or  absorption,  all 
their  minute  blood-vessels  are  destroyed  and  their  supply  of 
blood  cut  off.  I  have  seen  a  case  where  all  the  gluteal  muscles 
of  one  side  were  mortified,  from  the  small  arteries  having 
been  crushed  and  destroyed  in  a  railway  accident,  but  where 
the  larger  arteries  of  supply  did  not  sutfer.  The  horse  lived 
several  days. 

Necrosis  may  follow  the  separation  of  periosteum  from  the 
surface  of  a  bone,  when  it  is  either  stripped  off  or  raised  by 
effusion,  or  when  there  is  suppuration  beneath  it. 

Sometimes  a  tumour  will  slough  in  its  centre  from  defective 
supply  of  blood.  Again,  a  part  will  slough  from  the  application 
of  a  strong  chemical  agent,  as  corrosive  sublimate  or  arsenious 
acid. 

Blood  defective  in  quality  also  produces  mortification,  without 
being  accompanied  by  inflammation,  and  occasionally  mere 
passive  congestion  of  a  part  may  lead  to  its  death ;  but  this  is 
a  rare  occurrence. 

The  simplest  example  of  mortification  of  a  part,  not  from 
deficiency  of  blood  in  it,  is  that  from  strangulation,  as  in 
strangulated  hernia.  Here,  if  the  strangulation  is  sudden  and 
complete,  the  stagnation  is  equally  so,  and  the  death  of  the 
part  follows  very  quickly,  with  but  little  excess  of  blood  in  it. 
But  if  the  strangulation  be  less  in  degree,  the  veins  suffer  more 
from  the  gradual  compression  than  the  arteries  do ;  the  vessels 
become  engorged  with  blood  admitted  to  them  faster  than  it  can 
leave  them,  and  so,  after  intense  congestion,  mortification  ensues. 
(Example — inversion  of  the  uterus.) 

The  mortification  arising  from  passive  congestion  and  that 
from  strangulation  are  said  to  arise  from  defect  in  the  flow 
of  the  blood. 


58  TERMINATIONS  OF  INFLAMMATION. 

The  other  form  of  mortification  we  have  to  deal  with  is  that 
which  goes  under  the  denomination  of  Inflammatory  Mortifica- 
tion. The  death  of  an  inflamed  part  is  a  very  complex  matter, 
and  in  certain  kinds  of  it  stagnation,  degeneration,  and  pres- 
sure may  act  as  causes.  Thus,  inflammatory  congestion  may 
end  in  perfect  stagnation  of  the  blood  in  the  vessels,  the  blood 
so  stagnated  may  mortify  or  die,  and  this  death  of  the  blood 
may  lead  to  the  mortification  of  the  tissues  that  need  it  for 
their  support. 

Degeneration  of  the  proper  tissues  of  the  part  is  a  constant 
accompaniment  of  the  inflammatory  process,  and  this  degenera- 
tion may  result  in  death,  from  absence  of  the  proper  conditions 
of  nutrition;  and,  again,  eftusion  of  fluid  may  so  compress  the 
inflamed  part,  and,  by  the  swelling,  so  elongate  the  blood-vessels, 
as  to  diminish  the  influx  of  fresh  blood,  even  when  little  of  that 
which  is  in  the  part  is  stagnant. 

The  intensity  of  an  inflammation  is  not  alone  a  measure  of 
the  probability  of  mortification  ensuing,  neither  is  mere  debility, 
for  we  see  inflammations  without  mortification  in  Yery  enfeebled 
cases.  Want  of  condition  in  an  animal,  if  put  to  severe  exertion, 
will  often  cause  mortification  from  excessive  congestion,  espe- 
cially of  the  lungs,  the  mortification  here  seeming  to  arise  from 
complete  stagnation  of  the  blood  in  the  pulmonary  vessels,  with 
death  of  that  blood.  Again,  in  enteritis,  mortification  ensues 
from  severity  of  the  congestive  rather  than  the  truly  inflamma- 
tory process.  Cases  of  partial  gangrene  of  the  lungs,  depending 
on  pneumonia  affecting  bad-constitutioned  animals,  more  espe- 
cially if  such  have  been  kept  in  ill-drained  or  iU-ventilated 
stables,  are  not  uncommon. 

When  a  mortification  has  a  disposition  to  spread,  its  dark 
colour  is  gTadually  lost  in  the  surrounding  parts,  whereas,  when 
it  ceases  to  spread,  a  red  line,  called  the  line  of  demarcation^ 
separates  the  dead  from  the  living  parts.  This  line  is  always 
regarded  as  most  important,  indicating  that  sloughing  has  ceased 
to  spread,  and  that  a  process  has  begun  for  the  removal  of  the 
sphacelated  part  from  the  system. 

In  this  process,  consolidation  of  the  tissues  by  the  formation 
of  organizable  lymph  precedes  the  suppuration  and  ulceration ; 
and  thus  haemorrhage  from  the  vessels  and  infiltration  of  the 
decomposing  material  into  loose  structures  are  both  prevented. 


MORTIFICATION.  59 

The  final  act  in  the  separation  of  dead  tissue  is  that  of 
tilceration  of  portions  of  living  tissue,  which  are  in  immediate 
contact  with  the  dead.  A  groove  is  formed  by  this  ulceration, 
which  circumscribes  and  entrenches  the  dead  part,  and  then, 
gradually  deepening  and  converging,  undermines  it,  till,  reach- 
ing its  centre,  the  separation  is  complete,  and  the  slough  falls 
oft',  or  is  dislodged  by  the  discharge  of  the  ulcerated  living 
surface.  Concomitant  with  this  process  of  destruction,  one  of 
repair  is  set  up ;  as  the  ulcerated  groove  deepens,  so  do  granu- 
lation cells  rise  from  its  surface,  so  that,  as  one  might  say,  that 
which  was  yesterday  ulcerating  is  to-day  granulating ;  and  thus, 
very  soon  after  the  slough  has  separated,  the  whole  surface  of 
the  living  part,  from  which  it  was  detached,  is  covered  with 
granulations,  and  proceeds  like  an  ordinary  ulcer  towards  healing. 
There  is  one  peculiarity  in  mortification,  namely,  mortification 
hy  contact.  Thus  a  spot  of  mortification  of  the  size  of  a  five- 
sliilling  piece  is  discovered  upon  a  portion  of  intestine,  sur- 
rounded by  perfectly  healthy  structures,  until  the  portion  of 
the  intestine  in  immediate  contact  with  the  gangrenous  spot 
is  examined.  This  will  be  found  to  be  gangrenous  also, 
although,  when  divested  of  its  convolutions,  it  may  be  several 
feet  from  the  originally  mortified  spot,  the  intervening  length 
of  gut  being  free  from  mortification. 


CHAPTER  HI. 

SYMPTOMS  OF  INFLAMMATION. 

GENERAL  SYMPTOMS  OF  INFLAMMATION INFLAMMATORY  APPEAR- 
ANCES OF  THE  BLOOD — TREATMENT  OF  INFLAMMATION TREAT- 
MENT OF  CHRONIC  INFLAMMATION. 

The  symptoms  of  inflammation  are  of  two  kinds,  namely,  local 
and  constitutional.  The  first-named  have  been  already  de- 
scribed. The  constitutional  symptoms  are  those  indicative  of 
sympathetic,  symptomatic,  or  inflammatory  fever,  and  are  of  the 
greatest  importance,  indicating  the  nature  of  the  disease  when 
the  inflammation  exists  in  an  internal  organ  removed  from  sight 
or  touch,  and  often  guiding  the  method  of  treatment.  There 
are  some  inflammations  that  are  unattended  by  any  appreciable 
signs  of  fever;  others,  again,  by  symptoms  that  are  so  in- 
significant as  to  pass  unobserved ;  but  when  an  inflammation 
is  sufficiently  extensive,  the  general  system  is  disturbed  by  fever 
(pyrexia). 

Prominent  amongst  the  s}TTiptoms  of  inflammatory  fever 
are  rigors  (shiverings),  elevation  of  internal  temperature,  and 
debility ;  followed  by,  or  alternating  with,  increased  heat  of 
skin,  increased  frequency,  perhaps  force,  and  often  hardness  of 
the  pulse,  with  disturbance  or  derangement  of  the  natural 
functions  of  the  animal  body.  The  rigors  are  sometimes  severe, 
or  amounting  only  to  mere  chilliness,  a  slight  staring  of  the  coat 
being  the  only  sign ;  but  they  are  always  important,  as  they 
mark  the  outset  of  the  febrile  disturbance,  and  it  is  worth 
observing  that  rigors  more  commonly  attend  the  commencement 
of  spontaneous  inflammation  than  of  inflammation  caused  by 
external  injuries.  They  are  of  very  frequent  occurrence  in 
horses  that  j^resent  no  signs  of  local  disease ;  they  are  dull,  off 


GENERAL  SYMPTOMS.  61 

their  feed,  seemingly  little  wrong  or  amiss,  but  the  coat  is 
harsh  and  staring,  and  actual  shivering  is  easily  induced.  An 
animal  in  such  a  state  may  be  on  the  eve  of  an  attack  of 
severe  inflammation  of  some  important  internal  organ.  Gene- 
rally speaking,  the  febrile  state  succeeds  the  manifestations  of 
the  local  symptoms  of  the  inflammation,  and  therefore  it  may 
be  considered  generally  that  the  fever  is  the  natural  effect  of 
the  inflammation. 

The  inflammatory  fever  is  not  always  proportioned  in  its 
degree  of  violence  to  either  the  size  or  the  importance  of  the 
part  inflamed.  It  may  be  modified  in  the  outset,  or  very  early 
indeed,  by  the  nature  of  the  part  upon  which  the  inflammation 
has  seized.  In  inflammation  of  the  stomach  and  bowels,  and 
some  of  the  other  abdominal  organs,  and  particularly  in  traumatic 
peritonitis,  the  disease  has  a  peculiarly  depressive  effect  upon 
the  action  of  the  heart,  and  this  gives  a  peculiar  character  to 
the  fever,  lessens  the  amount  of  the  reaction,  or  abridges  its 
duration — affects  especially  the  character  of  the  pulse,  which  is 
here  small  and  thready,  and  carries  with  it  a  strong  tendency 
to  death,  by  failure  of  the  heart's  action  (asthenia). 

The  small  and  thready  pulse,  being  chiefly  observed  in  inflam- 
mation of  the  abdominal  organs,  has  been  called  the  ahdominal, 
pulse,  the  artery  resembling  a  hard  thrilling  thread. 

As  observed  in  connection  with  surgical  practice,  inflammatory 
fever  is  always  a  secondary  affection.  A  most  minute  description 
of  it  is  given  by  Professor  Miller,  which  I  sliall  endeavour  to 
condense,  and  apply  to  what  is  observable  in  Veterinary  Surgery; 
and,  like  Professor  Miller,  I  shall  consider  the  disorder  of  the 
general  frame  according  to  its  systems. 

Is^.  The  Nervous. — There  are,  if  one  might  judge,  dull  pains 
in  various  parts  of  the  animal  body,  stiffness  in  the  loins  and 
in  the  limbs,  restlessness,  and  a  variety  of  postures,  especially 
of  the  limbs,  shifting  from  one  leg  to  another,  pointing  of  the 
feet ;  and  when  the  respiratory  organs  are  not  the  seat  of  the 
inflammation,  frequent  lying  down  for  a  short  time  ;  no  desire  for 
natural  movement,  dulness,  walking  performed  sluggishly,  and 
with  manifest  disinchnation ,  watchfulness,  the  senses  of  sight 
and  hearing  being  evidently  exalted ;  and  in  aggravated  cases 
as  those  arising  from  neglected  wounds  in  the  feet,  delirium 
and  coma  may  ensue,  the  eyes  red  and  suffused,  the  visible 


62  SYMPTOMS  OF  INFLAMMATION. 

mucous  membrane  red  and  injected,  and  the  skin  hot  and  dry, 
or  partial  sweats  bedew  the  body. 

2d.  The  Vascular. — The  pulse  indicates  excitement ;  it  is 
increased  in  frequency,  ranging  from  60  to  90,  or  even  to  120 
per  minute,  hard,  rolling  like  a  cord  below  the  finger,  and 
yielding  but  little  to  its  pressure.  The  arterial  coats  are 
exercising  an  increased  amount  of  tonicity,  and  resist  the  im- 
pulse of  the  blood;  or  an  irregularity  of  movement  in  the 
artery  may  exist,  and  thus  a  thrill  or  jar  is  imparted  to  the 
finaer.  There  is  increased  fulness,  as  if  the  vessel  itself  were 
enlarged  and  held  a  larger  quantity  of  blood  at  each  impulse ; 
the  heart  is  acting,  not  only  more  rapidly,  but  more  powerfully, 
than  in  health,  and  the  circulation  is  truly  accelerated ;  fre- 
quency, hardness,  or  thrilling  is  seldom  absent,  but  fulness  may 
be  wanting,  and  the  pulse  may  be  small  instead  of  full.  This 
is  observable,  as  already  mentioned,  in  serious  abdominal  dis- 
ease. The  small  thready  pulse  always  exists  in  connection 
with  great  nervous  depression,  and  debihtated  through  rapid 
action  of  the  heart,  to  which  circumstance  its  smallness  is  pro- 
bably due.  In  aftections  of  the  brain,  and  in  non-inflammatory 
disorders  of  the  stomach  producing  coma,  the  pulse  is  commonly 
slow  and  full,  the  suspension  of  cerebral  influence  appearing 
to  diminish  the  rapidity,  without  affecting  the  force  of  tlie 
heart's  action.  There  are  peculiarities  also  to  be  taken  into 
account.  The  pulse  may  be  naturally  slow,  intermittent,  or 
rapid ;  in  the  common-bred  cart-horse,  perhaps  not  above  30  or 
35  ;  in  the  thorough  or  highly-bred  horse,  especially  if  he  be  of 
a  nervous  temperament,  45  or  50 ;  and  in  some  animals  of  both 
descriptions  intermitting,  from  some  unknown  cause  or  peculiar 
idiosyncrasy.  Allowance  must  be  made  for  these  w^ien  previous 
inquiry  has  satisfied  us  that  our  patient  is  the  subject  of  one  or 
other  of  these  peculiarities. 

Zd.  The  Ecspiratory. — Eespiration  is  quickened,  the  breath 
is  hotter  than  usual — in  stable  phraseology,  the  horse  Uows. 

Ath.  Tlie  Digestive. — The  appearance  of  the  tongue  does  not 
vary  in  our  patients  as  much  as  in  the  human  being,  but  the 
mouth  is  dry,  hot,  and  injected,  soapy,  lathery,  and  sometimes 
the  tongue  is  contracted,  and  the  secretions  of  the  mouth  sour 
or  even  foetid.  There  is  sometimes  very  great  thirst,  loss  of 
appetite  and  loathing  of  food,  and  the  bowels  are  constipated. 


GENEKAL  SYMPTOMS.  C3 

bth.  Tlie  Secerning. — The  secretions  and  excretions  in  general 
are  materially  diminished ;  the  bowels  are  constipated,  mainly 
from  want  of  mucous  secretion  from  their  lining  membrane  ;  the 
skin  is  hot  and  dry ;  or,  if  pain  be  the  characteristic  of  the  local 
inflammation,  there  will  be  partial  sweats  on  the  surface  of  the 
body ;  the  mouth  is  parched  and  dry ;  the  urine  is  scanty,  high- 
coloured,  sparingly  aqueous,  and  holding  much  saline  matter  in 
solution. 

Qth.  Tlie  Nutritive. — Digestion  and  assimilation  are  interrupted; 
as  the  fever  advances,  so  does  emaciation ;  and  strength  becomes 
more  and  more  reduced. 

As  already  observed,  there  is  no  fixed  relation  between  the 
degree  or  intensity  of  internal  inflammations  and  the  constitu- 
tional fever  attending  them ;  nor  is  the  fever  ahvays  propor- 
tioned in  its  degree  of  violence  to  either  the  size  or  importance 
of  the  part  inflamed.  This  is  insisted  on  by  Drs.  Alison  and 
Watson,  and  their  conclusions  may  be  accepted,  and  shortly 
stated.  Dr.  Alison  writes : — "  In  some  cases  where  we  are 
sure  that  we  have  had  inflammation  going  on  under  our  inspec- 
tion to  extensive  effusion  of  pus,  the  pulse  has  been  feeble,  the 
skin  cool  and  damp,  and  the  patient  exhausted  and  faint  on 
the  slightest  exertion ;  while  in  others  there  is  high  and  more 
inflammatory  fever,  and  in  some  of  these  the  organ  inflamed 
has  been  so  to  no  extent,  and  its  function  comparatively  little 
affected,  but  yet  the  patient  has  become  comatose  early,  as  in 
typhus,  and  died  so."  Every  veterinarian  of  experience  will  be 
able  to  bear  out  the  correctness  of  these  observations  from  the 
statistics  of  his  own  practice.  Many  inflammations  will  have 
come  under  his  notice  where  the  danger  has  been  compara- 
tively slight,  and  the  fever  high ;  and  others  where  the  local 
inflammation  has  been  most  imminent,  and  the  accompany- 
ing fever  has  been  hardly  observable.  The  situation,  the 
extent,  and  the  degree  of  the  local  inflammation  being  the  same, 
the  fever  generally  runs  higher  in  the  young  plethoric  animal 
than  in  the  more  aged  class  of  patients.  Young  horses  newly 
bought  from  the  breeder,  and  brought  into  large  towns,  suffer 
more  severely  from  fever,  when  the  local  disease  is  perhaps 
very  trivial,  than  those  which  are  used  to  town  work,  town  diet, 
and  management,  and  are  in  what  is  termed  condition.  The 
type  of  the  inflammatory  fever  is  modified  by  other  circum- 


64  SYMPTOMS  OF  INFLAMMATION. 

stances,  such  as  tlie  state  of  the  atmosphere,  ventilation,  drain- 
age, and  when  any  zymotic  disease  is  associated  with  the 
local  inflammation.  Animals  which  are  located  in  country 
districts  present  a  much  higher  type  of  fever,  and  bear  blood- 
letting much  better  than  those  crowded  together  in  large  town 
establishments.  Again,  the  fever  is  modified  in  its  expression 
by  the  nature  of  the  part  that  is  inflamed.  The  pulse  and  fever 
that  accompany  acute  laminitis  are  at  once  characteristic  of  the 
disease,  and  no  man  of  common  observing  powers  would  fail  to 
recognise  this  formidable  malady  if  he  once  felt  the  pulse,  strong, 
hard,  and  full,  and  continuing  so  for  days  even  after  the  vital 
powers  have  begun  to  fail.  The  type  of  the  fever  undergoes 
a  change  when  suppuration  takes  place  ;  when  it  (the  fever)  con- 
tinues long,  and  when  mortification  or  gangrene  occurs  to  any 
extent.  The  febrile  state  generally  follows  the  local  disease,  but 
there  is  good  reason  to  believe  that  the  jpyrexial  condition  and 
the  condition  of  inflammation  in  a  part  may  be  excited,  in  some 
instances,  conjointly;  or,  at  all  events,  their  periods  of  com- 
mencement may  correspond  so  closely  that  it  is  difficult  to 
conceive  that  one  is  the  effect  of  the  other.  There  is  every 
reason  to  believe  that,  in  some  instances,  the  fever  precedes 
the  local  inflammation ;  as  in  strangles,  where  it  may  be  said 
to  be  present  in  some  cases  for  an  indefinite  but  short  period 
before  there  is  any  manifestation  of  local  symptoms.  The  animal 
is  then  said  to  be  " breeding  strangles'/  and  in  epizootic  pneu- 
monia in  the  horse,  I  am  convinced  that,  in  many  instances, 
the  local  inflammation  succeeds  the  fever,  and  that  much  of  the 
non-success  in  the  treatment  of  this  disease  has  arisen  from 
iraorance  of  this  fact. 

When  inflammation  proceeds  to  suppuration  a  severe  fit  of 
shivering  is  often  the  first  indication  of  the  formation  of  pus. 
The  nature  of  the  fever  then  alters,  and  becomes  characterised 
(except  in  laminitis,  and  acute  suppurative  arthritis,  or  an  open 
joint)  by  softness  and  feebleness  of  the  pulse,  and  by  much  ner- 
vous prostration  and  debility.  A  copious  formation  of  pus  may 
proceed  from  a  mucous  membrane  without  any  appreciable 
degree  of  suffering,  whilst  a  most  trifling  amount  of  pus  from  a 
serous  or  synovial  membrane  will  be  often  associated  with  fever 
of  even  a  fatal  character.  In  any  case,  the  character  of  the 
fever  depends  greatly  on  the  constitution  of  the  patient :  if  this 


GENERAL  SYMPTOMS.  65 

be  good,  tlie  fever  is  cliaracterised  by  much  heat,  and  a  strong, 
full  pulse;  on  the  contrary,  if  the  animal's  constitution  be 
impaired,  or  if  it  be  out  of  condition,  the  fever  is  of  a  low 
type,  called  typhoid ,  asthenic,  or  adynamic,  and  is  charac- 
terised by  prostration,  sinking  of  the  pulse,  great  impairment 
of  the  heart's  action,  with  a  tendency  to  collapse ;  and  the  skin 
is  covered  by  cold,  clammy  sweats.  Sometimes  these  adynamic 
characters  pass  into  that  typhoid  state  in  which  nervous  symp- 
toms, such  as  delirium,  coma,  and  tremors,  prevail.  These 
characters  are  known  as  nervous  or  ataxic.  There  is  uncon- 
sciousness, grinding  of  the  teeth,  the  mouth  becomes  foetid,  the 
tongue  dry,  and  tremors  affect  the  voluntary  muscles.  This 
form  sets  in  as  a  result  of  some  unhealthy  tendency  of  the 
inflammatory  process,  or  when  mortification  of  the  inflamed 
part  occurs ;  but  any  cause  by  which  the  system  becomes 
vitiated  will  bring  about  this  kind  of  fever  without  death 
of  the  inflamed  part,  such  as  the  poison  of  rinderpest,  acute 
glanders,  and  other  allied  diseases.  Putrescence  of  the  pro- 
ducts of  inflammation,  degenerating  and  decomposing,  poison 
the  fluids  circulating  amongst  them,  and  when  absorbed  induce 
the  typhoid  state.  This  form  of  fever  tends  to  death  by  com- 
plete sinking  of  the  circulation,  with  diminution  and  loss  of 
animal  heat ;  or  deepening  stupor,  with  oppressed  respiration, 
supervenes ;  or  the  animal  dies  by  combination  of  both  asthenia 
and  coma. 

Be  it  understood,  however,  that  sympathetic  inflammatory 
fever  is  especially  marked  by  the  absence  of  certain  symptoms 
which  distinguish  the  idiopathic  fever,  more  especially  of 
petechise,  and  of  any  special  eruption  on  the  skin. 

INFLAMMATORY  APPEARANCES  OF  THE  BLOOD. 

The  chief  appreciable  change  in  the  constitution  of  the  blood 
is  a  great  increase  in  the  quantity  of  its  fibrine,  which,  accord- 
ing to  Andral  and  others,  may  range  from  2 J-  to  10  per  1000 
parts.  It  is,  however,  a  very  difficult  matter  to  ascertain  with 
any  certainty  the  exact  increase,  for  it  is  impossible,  by  any 
process  yet  discovered,  to  separate  the  fibrine  from  the  white 
corpuscles  of  the  blood. 

Some   pathologists   state   that   there  is   an   increase   of  the 


60  SYMPTOMS  OF  INFLAJklMATION. 

red  globules  during  the  very  early  stage  of  the  inflammation ; 
but  all  are  agreed  that,  as  the  inflammation  advances,  these 
diminish  in  number,  falling  considerably  below  their  normal 
quantity. 

As  already  pointed  out,  the  white  corpuscles  are  increased  in  the 
vessels  and  tissues  of  the  inflamed  part,  and  where  the  lymphatic 
system  is  excited  by  the  inflammation,  in  the  circulation  generally. 

The  buffy  coat  is  always  found  in  blood  drawn  from  the 
healthy  horse;  consequently,  this  appearance  cannot  be  de- 
pended upon  as  proving  the  existence  of  inflammatory  disease, 
but  the  fibrine  of  the  blood  during  the  inflammatory  process 
has  an  unusual  tendency  to  separate  from  the  colouring  matter, 
and  to  the  aggregation  of  its  particles  during  coagulation ; 
the  clot  or  crassamentum  is  firmer  and  denser  than  that  of 
healthy  blood,  and  the  surface  is  hollowed  out  into  a  cup- 
like form,  in  which  case  the  blood  is  said  to  be  both  buffed  and 
cupped. 

Much  difference  of  opinion  exists  as  to  the  production  of  the 
buffy  coat,  and  I  would  beg  to  refer  the  reader  to  the  observa- 
tions of  Dr.  Eichardson  of  London,  Professor  Lister,  London, 
and  others,  for  further  information. 


TREATMENT  OF  INFLAMMATION. 

If  the  practitioner  is  called  to  a  case  of  injury  of  any  kind, 
his  first  duty  is  to  prevent  inflammation  by  every  means  in 
his  power.  In  the  case  of  a  punctured  foot,  or  any  other  in- 
jury where  the  cause  is  still  remaining,  he  has  to  remove  that 
cause,  and,  by  enlarging  the  wound,  allow  the  escape  of  any 
blood  or  serum  that  may  have  collected  around  the  foreign 
body,  and  in  its  immediate  vicinity.  He  will  also  apply  soothing 
remedies  to  the  part,  such  as  warm  or  cold  fomentations  or 
poultices,  and  enjoin  strict  quietude.  I  prefer  warm  to  cold 
applications,  and  recommend  them  strongly  in  the  majority  of 
cases.  It  is  also  a  safe  and  commendable  practice  to  adminis- 
ter a  purgative,  consisting  of  from  four  to  six  drachms  of  aloes 
in  a  ball :  by  pursuing  such  a  line  of  treatment,  every  part  of 
the  inflammatory  process  may  be  averted,  or  at  least  modified 
to  a  considerable  extent. 

But  if  inflammation  be  fully  established,  and  the  exciting 


TREATMENT  OF  INFLAMMATION.  67 

cause  still  remain,  the  duty  of  the  practitioner  is  to  effect 
its  removal  as  speedily  and  as  effectually  as  possible.  This 
having  been  accomplished,  the  inflammation  may  be  subdued 
by  comparatively  slight  means,  and  with  little  danger  to  the 
patient.  But  if  this  important  preliminary  be  neglected  or 
imperfectly  performed,  the  most  powerful  remedial  measures 
may  be  employed  with  no  avail.  If,  for  example,  the  practi- 
tioner be  called  to  a  case  of  lameness  caused  by  a  foreign 
body  in  the  foot,  or  by  pressure  of  the  shoe  upon  some  one 
particular  spot,  he  will  remove  that  shoe  or  that  foreign 
body,  give  an  outlet  to  the  serum  or  pus  which  it  may  have 
created,  and  by  a  gentle  purge,  a  poultice,  and  rest,  dissipate 
all  the  formidable  symptoms,  the  local  inflammation,  and  the 
general  fever.  But,  on  the  other  hand,  if  he  leaves  the  foreign 
body  in  the  inflamed  part;  neglects  to  give  an  outlet  to  the 
discharge ;  gives  purgatives  and  sedatives ;  bleeds,  foments, 
and  poultices ;  blisters,  or  pursues  all  the  most  heroic  methods 
of  treatment — what  will  be  the  result  ?  Increase  of  the  lame- 
ness, of  the  local  inflammation,  and  of  the  accompanying 
fever;  and  if  death  of  the  animal  does  not  ensue,  the  pus 
will  force  its  way  out  at  the  coronet,  disconnecting  the  hoof 
from  the  sensitive  foot,  and  producing  such  a  morbid  con- 
dition of  the  part  as  may  take  a  long  time  to  recover.  This 
is  not  a  fanciful  illustration,  as  the  majority  of  practitioners 
can  bear  testimony,  and  some  of  them  to  their  cost  and 
annoyance.  Let  it  be  remembered  that  the  first  step  in  the 
treatment  of  every  disease,  whether  surgical  or  medical,  is  to 
remove  the  cause:  all  treatment  is  of  minor  importance  com- 
pared with  this.  "  Eemove  the  cause,  and  the  effect  will 
cease,"  is  an  old  maxim  which  should  never  be  forgotten  by 
the  veterinary  surgeon.  When  the  cause  has  been  as  effec- 
tually removed  as  may  be  in  his  power,  he  will  be  in  a 
position  to  proceed  with  remedial  measures.  Those  which  are 
opposed  to  the  advance  and  persistence  of  inflammation,  are 
termed  antiphlogistians ;  and  one  of  the  most  important  of 
these  is  blood-letting,  which  is  of  two  kinds,  namely,  local  and 
general. 

Until  a  recent  period,  bleeding  was  considered  by  almost  all 
as  the  great  thing  needful  in  all  acute  inflammatory  affections — 
that  it  cut  short  as  weU  as  cured  every  inflammation.     I  shall 


68  SYMPTOMS  OF  INFLAMMATION. 

now  endeavour  to  explain  the  views  of  the  old  and  of  the  new 
school  of  therapeutics,  upon  this  important  point. 

The  Old  View. — Of  all  antiphlogistic  remedies,  the  most 
important  was  blood-letting;  and  the  effect  of  general  blood- 
letting in  arresting  inflammation  was  said  to  be  owing  princi- 
pally to  its  lessening  the  force  of  the  heart's  action,  causing 
derivation  of  the  blood  from  the  part,  and  facilitating  the  action 
of  other  remedies.  "  A  sedative  result  on  the  heart's  action  is 
effected  by  withdrawing  from  the  central  organ  of  circulation  a 
part  of  its  natural  stimulus,  the  blood,  by  which  its  action  is 
habitually  maintained,  and  partly  by  the  intervention  of  an  im- 
pression produced  on  the  nervous  system ;  it  being  well  known 
that  the  sudden  diminution  of  pressure  on  the  brain  and  medulla 
oblongata  has  a  remarkable  effect  in  diminishing  the  frequency 
and  force  of  the  heart's  action." 

Dr.  Alison  says : — "  The  effect  of  blood-letting  in  causing 
derivation  from  parts  actually  inflamed  to  other  parts  of  the 
body  has  not  been  studied  with  so  much  care  as  might  have 
been  expected  from  the  pains  bestowed  upon  it  by  Haller. 
Whether  this  effect  is,  as  he  thought  he  had  ascertained,  in- 
explicable on  merrely  mechanical  principles ;  or  whether,  as 
Magendie  and  Poisenille  assert,  it  is  merely  the  effect  of  the 
contractile  power  of  the  vessels,  and  the  forced  state  of  disten- 
sion in  which  they  exist  during  life,  causing  a  flow  to  any 
point  where  an  opening  is  made;  it  is  quite  certain  that  a 
movement  in  that  direction  is  immediately  perceived  in  all  the 
small  vessels  that  can  be  seen  under  the  field  of  the  microscope, 
on  a  puncture  being  made  in  any  one  of  them ;  and  in  Haller's 
observations  it  distinctly  appeared  that  this  movement  often 
inverted  the  natural  course  of  the  circulation,  and  often  extended 
to  blood  stagnating  in  vessels,  and  caused  globules  to  separate, 
and  become  distinct,  which  had  previously  combined  in  irregular 
masses.  This  being  so,  it  cannot  be  doubted  that  similar  changes 
must  be  effected,  in  a  greater  or  a  less  degree,  in  the  blood  stag- 
nating in  inflamed  parts,  when  an  exit  is  given  to  the  blood  from 
other  parts  of  the  cu^culatory  system,  whether  by  general  or  local 
blood-letting.  And  it  does  not  seem  possible  to  understand  on 
what  other  principle  than  this  blood-letting  can  be  useful,  as 
it  undoubtedly  is,  in  certain  cases  of  inflammation,  chiefly  ab- 
dominal, when   the   pulse   is   smaller   and   even  feebler   than 


TREATMENT  OF  INFLAMMATION.  69 

natural,  but  becomes  fuller  and  stronger ;  or  in  others  (cliiefly 
of  the  head  and  abdomen  likewise),  when  it  is  slower  than 
natural,  small  and  sharp,  and  becomes  more  frequent  and  fuller 
after  the  evacuation." 

The  action  of  other  remedies  is  facilitated  by  blood-letting. 
"  By  lessening  that  morbid  impetus  of  blood  and  increased  tone 
of  the  vascular  coats  by  which,  during  the  state  of  inflammatory 
fever,  the  natural  secretions  are  apparently  impeded,  and  at 
the  same  time  promoting  absorption  into  the  blood,  as  loss  of 
blood  is  well  known  to  do,  it  favours  the  effect  of  all  other 
evacuating  remedies ;  and  further,  by  its  precedence  it  renders 
certain  remedies — as  mercury  and  opium — decidedly  beneficial, 
which  otherwise  would  have  proved  either  inoperative  or  abso- 
lutely injurious." 

To  this  view  is  opposed  that  of  the  late  school  of  therapeutics ; 
and  by  the  followers  of  that  school  it  is  believed  that  all 
bleedings  and  other  antiphlogistic  remedies  are  entirely  opposed 
to  a  sound  pathology.  Dr.  Bennett  says,  that  when  an  exuda- 
tion has  once  occurred,  in  order  that  it  may  be  removed,  it 
must  undero^o  certain  chancres  or  transformations,  for  which  an 
increased  supply  of  blood  to  the  part  is  absolutely  necessary ; 
that  blood-letting  can  in  no  way  lessen  the  amount  of  blood  in 
an  inflamed  part,  or  assist  in  the  excretion  of  morbid  products 
from  tlie  vital  fluid ;  that  the  character  of  the  pulse  cannot  be 
a  safe  guide  to  the  propriety  of  bleeding,  as  its  condition  is  the 
result,  and  not  the  cause,  of  the  inflammation;  and  that  the 
increased  throbbing  and  circulation  of  blood  about  an  inflamed 
part  is  a  result  of  the  inflammatory  process — a  wise  provision, 
as  he  says,  of  nature,  to  further  vital  changes,  and  one  which 
ought  to  be  assisted  rather  than  opposed.  Such  are  the  views 
of,  first,  the  antiphlogistic  school,  ^nd,  secondly,  of  those  who 
hold  that  it  is  impossible  to  cut  short  an  infiammation,  and 
make  it  the  rule  of  practice  to  further  the  natural  changes 
necessary  for  the  removal  of  the  products  of  the  inflammatory 
process. 

I  must  confess  that  I  can  neither  assent  to  the  views  of  the 
extreme  antiphlogistians  nor  to  those  of  the  writers  who  con- 
demn bleeding  altogether,  being  quite  confident  that  I  have  seen 
many  cases  of  congestive  inflammatory  disease  cut  short  by  a 
timely  abstraction  of  Hood.     I  have  experience  of  the  method 


70  SYMPTOMS  OF  INFLAMMATION. 

of  treatment  that  was  in  vogue  twenty  years  ago,  when  repeated 
and  heavy  blood-letting  was  the  rule,  and  from  my  recollections 
I  cannot  but  severely  censure  such  an  irrational  method.  Where 
local  bleeding  can  be  effected,  it  is  preferable  in  all  cases  to 
general  blood-letting. 

General  blood-letting  is  commonly  performed  by  opening 
the  jugular  vein  in  our  patients.  For  this  purpose  a  fleam  is 
preferable  to  a  lancet,  for  reasons  that  need  not  be  discussed 
here.  The  operation  is  termed  venesection,  or  phlebotomy. 
If  the  blood  is  drawn  from  an  artery,  the  operation  is  called 
arteriotomy,  and  is  best  performed  by  a  lancet.  In  some  cases 
of  cerebral  meningitis,  the  temporal  artery  has  been  opened 
with  good  effect,  and  the  wound  in  the  skin  closed  by  means 
of  a  pin,  retained  in  its  position  by  a  small  quantity  of  tow  or 
thread.  If  the  haemorrhage  is  not  arrested  by  this  method  in 
the  case  of  arteriotomy,  a  pin  or  needle  can  be  placed  under- 
neath the  artery.  By  acupressure  in  this  way,  it  will  be  most 
effectually  arrested,  at  the  cost,  however,  of  the  vessel,  which 
will  become  obliterated  at  that  spot.  But  this  is  of  no  moment, 
as  the  collateral  circulation  will  be  sufficient  to  maintain  the 
integrity  of  the  part. 

A  cow  requires  a  larger  fleam  than  the  horse.  Of  this  fact 
the  instrument  maker  is  well  aware,  and  the  intending  phlebo- 
tomist  can  get  fleams  suitable  for  all  his  patients. 

Local  blood-letting  is  performed  upon  the  inflamed  part,  or 
as  near  to  it  as  possible,  and  the  object  is  speedily  to  unload 
the  engorged  blood-vessels.  It  may  be  done  by  scarification, 
incision,  or  puncture.  In  conjimctivitis,  for  example,  it  may  be 
drawn  from  the  vessels  of  the  inflamed  part  by  scarifying  the 
inner  surface  of  the  eyelids,  or  by  opening  the  angular  vein.  In 
inflammatory  disease  of  the  foot,  any  quantity  can  be  obtained 
by  puncturing  the  coronary  plexus  of  veins. 

When  general  blood-letting  from  the  jugular  is  practised,  the 
animal's  head  should  be  elevated,  and  a  full  gtream  of  blood 
allowed  to  flow  from  a  sufficiently  large  orifice  in  the  vein. 
If  this  be  done,  a  smaller  amount  of  blood  drawn  will  make  a 
much  gTeater  impression  on  the  pulse  than  when  the  orifice  in 
the  vein  is  small,  the  blood  flowing  in  a  trickling  stream,  and 
the  head  depressed. 

The  question  of  a  second  blood-letting  remains  to  be  con- 


TREATMENT  OF  INFLAMMATION.  71 

sidered.      If  the  blood  flows  freely  from  the  vein  during  the 
first  bleeding,   and   if   the  animal   stands  a  full  blood-letting, 
say  from  five  to  seven  quarts,  without  manifesting  symptoms 
of  syncope  by  sighing  and  sweating,  he  may  be  considered  to 
have   borne  the  operation  well;    but  if,    on  the  contrary,   the 
patient  manifests  these  signs  shortly  after  the  vein  is  opened, 
it  will  be  well  for  the  practitioner  to  desist  from  further  deple- 
tion.    The  urgent  symptoms  of  the  disease  may  by  the  bleeding 
be  relieved,  but  may  return  again  after  a  longer  or  shorter  period, 
and  demand  a  repetition  of  the  remedy  ;   but  before  this  is 
done  the  reaction  of  the  system  generally,  the  local  symptoms, 
and  the  urgency  for  relief,  must  be  taken  into  consideration. 
If  the  reaction  be  great,  and  of  a  sthenic  character,  with  the 
pulse  full  and  strong,  the  operation  may  be  repeated ;  but  if  it 
be  asthenic,  the  pulse  rapid,  quick,  and  jerking,  the  respira- 
tion   oppressed,   with    partial   sweats    on    the   body,   and   the 
extremities   cold,   the   bleeding   is   not  to  be  repeated.      The 
appearance  of  the  blood  after  it  has  coagulated  is  not  of  very 
great   service   as   an   indication   either   for   re-bleeding  or  re- 
fraining from  it.      The  firmness    of   the   coagulum   has   been 
considered  as  a  mark  of  the  tonic  state  of   the  system,    and 
as  a  warranty  for   repeating   the    bleeding  when   the   part  is 
as  yet  unrelieved,  and  the  reaction  continues  of  the  sthenic 
type.      On  the  contrary,  a  looseness  of  the  consistence  of  the 
clot  is  a  sign  of  weakness,  and  that  the  bleeding  should  not 
be  repeated. 

The  proportion  of  serum  to  the  crassamentum,  and  also  its 
altered  character,  are  arguments  for  or  against  bleeding.  If 
the  quantity  of  serum  is  large,  the  bleeding  should  not  be 
repeated.  When  the  properties  of  the  serum  are  so  altered 
that  it  coagulates  and  forms  one'  mass  with  the  clot,  bleed- 
ing is  always  injurious ;  and  when  the  serum,  which  has  little  or 
no  affinity  to  the  red  globules  in  health,  readily  dissolves  them, 
it  is  an  unerring  sign  that  further  bleeding  should  be  avoided. 

There  are  many  instances  for  not  esteeming  the  firmness 
and  dimensions  of  the  buffed  coat  as  an  indication  for  bleed- 
ing, even  when  it  has  the  cupped  appearance;  for  this  con- 
dition exists  in  many  debilitating  aff'ections,  more  especially  in 
epizootics  affecting  the  fibrous  and  serous  membranes ;  and  no 
one  now  thinks  of  bleeding  in  these  diseases. 


72  SYMPTOMS  OF  INFLAMMATION. 

It  is  well  known  that  the  buffy  or  sthenic  appearance  of  the 
blood  depends  greatly  upon  the  manner  in  which  the  blood  is 
drawn.  If  this  is  done  in  a  full  stream,  these  characters  are  ever 
present  in  the  healthy  horse ;  but  if  the  stream  be  slow,  and  if 
the  blood  runs  down  the  side  of  the  vessel,  there  will  be  little 
or  no  buffy  appearance.  The  form  of  the  vessel  into  which 
the  blood  is  received,  and  its  temperature,  will  also  affect  the 
process  of  its  coagulation.  Therefore,  as  already  mentioned,  the 
mere  appearance  of  the  blood  is  not  a  guide  to  the  repetition 
of  the  bleeding.  As  a  rule  to  be  safely  followed,  one  good 
bleeding  from  a  strong  and  previously  healthy  patient  is  suffi- 
cient in  nearly  all  cases. 

Epizootic  influences  are  opposed  to  blood-letting,  and  in 
epizootics  of  all  kinds,  even  if  the  temperature  indicates  high 
fever,  above  104°  F.,  we  should  not  hastily  have  recourse  to  the 
fleam,  but  should  remember  that  the  disease  depends  on  a  mor- 
bid poison,  has  a  course  to  run,  and  is  not  amenable  to  the  mere 
abstraction  of  blood.  "When  the  inflammatory  fever  has  been 
insidious,  so  that  the  first  stage  has  passed  over  unchecked,  or 
modified  by  previously  existing  constitutional  disease,  or  com- 
plicated with  organic  local  disease ;  or  when  they  denote  debility, 
exhaustion,  or  the  so-called  typhoid  state,  they  generally  prove 
improper  cases  for  blood-letting,  even  when  seen  within  the 
first  few  days." — (AiTKEX.) 

The  next  important  class  of  antiphlogistic  agents  in  the 
treatment  of  many  inflammations  consists  of  purgatives,  more 
especially  the  aloetic  in  the  horse,  saline  in  the  ox  and  sheep, 
and  of  jalap  or  castor  oil  in  the  dog.  (1.)  They  act  by  remov- 
ing from  and  freeing  the  intestinal  canal  of  accumulated  food 
and  faeces,  or  other  irritating  and  acrid  matters.  (2.)  They  sub- 
due the  inflammatory  tendency  by  causing  a  discharge  of  a  large 
quantity  of  serous  fluid  charged  with  albumen.  They  direct 
large  quantities  of  blood  to  the  intestinal  mucous  membrane, 
and  they  determine  to  the  same  surfaces  a  large  amount  of 
nervous  influence,  and  thus  act  on  the  principle  of  derivation. 
They  diminish  effusion,  and  check  the  force  of  the  heart's 
action.  Aloes,  in  virtue  of  its  nauseating  properties,  is  most 
valuable. 

The  use  of  purgatives  is  indicated  in  inflammatory  fever 
arising  from  all  external  injuries,  unless  they  be  of  such  gravity 


TREATMENT  OF  INFLAMMATION.  73 

as  to  necessitate  the  use  of  slings  from  the  outset ;  if  such  be 
the  case,  the  weight  of  the  animal  being  thrown  upon  the 
abdominal  viscera,  renders  the  use  of  purgatives  dangerous. 
In  inflammatory  fever  arising  from  inflammations  of  mucous 
membranes,  or  when  at  any  time  the  mucous  membranes 
exhibit  signs  of  irritation,  even  after  an  external  injury,  the 
administration  of  purgatives,  more  especially  in  the  horse,  is 
contra-indicated.  In  thoracic  affections,  even  when  the  serous 
membranes  are  affected,  they  should  be  given  with  caution, 
but  they  are  of  great  service  in  encephalitis,  hepatic  con- 
gestions, &c. 

Opium. — To  subdue  pain  and  soothe  the  nervous  system, 
there  is  no  remedy  to  equal  opium.  Its  use  is  of  vital  im- 
portance in  some  inflammations,  especially  in  inflammation  of 
the  intestines. 

Aconite  is  another  valuable  remedy.  Its  beneficial  effects 
are  more  apparent  in  cases  of  inflammation,  accompanied  by 
excitement  rather  than  pain ;  it  improves  the  tone,  whilst 
it  diminishes  the  rapidity,  of  the  heart's  action.  Belladonna 
is  a  favourite  remedy  with  some  practitioners,  but  it  is  not  so 
useful  as  either  opium  or  aconite ;  it,  however,  seems  to  exer- 
cise a  beneficial  efiect  upon  inflammations  of  the  larynx. 

Antimony  in  all  its  forms  has  no  effect  upon  the  heart's 
action  in  the  horse  or  ox,  but  is  successfully  employed  in  the 
treatment  of  canine  inflammations. 

Mercury  is  but  seldom  employed  in  the  treatment  of  in- 
flammation; its  use  in  both  the  horse  and  the  ox  has  been 
followed  by  alarming,  and  sometimes  fatal,  symptoms.  For 
many  years  cases  have  been  treated  by  me  without  the  use  of 
mercury,  and  I  am  of  opinion  that  it  may  be  excluded  from  the 
list  of  antiphlogistic  remedies. 

Alkaline  remedies  in  some  manner  retard  the  formation  of 
fibrogenous  elements  in  the  tissues ;  they  also  increase  the 
secretion  of  urine,  and  particularly  the  expulsion  by  this 
channel  of  the  products  derived  from  destruction  of  the  albu- 
minous compounds  of  the  body.  Alkalies,  having  combined 
with  acids  in  the  system,  generally  pass  out  of  the  body  as 
salts,  and  tend  to  leave  behind  them  an  excess  of  alkali  in  the 
blood.  For  this  reason,  the  neutral  salts  of  the  alkalies  suit 
the  lower  animals,  more  especially  the  horse  and  ox  (in  which 


74  SYMPTOMS  OF  INFLAMMATION. 

acidity  is  not  such  a  normal  condition  of  system  as  in  man  and 
the  dog).  We  therefore  find  that  the  nitrate  of  potash  is  a 
most  valuable  antiphlogistic. 

Stimulants. — When,  after  the  subsidence  of  inflammatory 
excitement,  the  process  of  repair  does  not  progress  satisfactorily, 
when  in  fact  it  hangs  fire,  either  from  excessive  severity  of  the 
inflammation,  depressive  treatment,  or  other  influence,  it  may 
be  necessary  to  have  recourse  to  stimulants  applied  to  the  part 
itself  if  superficially  situated,  or  administered  internally,  when 
the  seat  of  the  inflammation  is  beyond  our  reach.  But  stimu- 
lants, particularly  alcoholic  stimulants,  whether  wine,  spirits,  or 
beer,  must  be  very  carefully  administered — particularly  in  horse 
practice — and  only  persisted  in  when  their  beneflcial  effects  are 
perceptible.  If  they  improve  the  appetite  or  pulse  they  may  be 
continued,  but  not  otherwise. 

Local  stimulants  to  superficial  parts,  after  the  subsidence  of 
active  symptoms,  will  often  promote  their  recovery;  thus  an 
ulcer  or  superficial  mucous  membrane  may  be  touched  with 
nitrate  of  silver  or  other  stimulant,  or  stimulated  with  cold 
water.  Where  joints  or  synovial  membranes  are  to  be 
treated,  the  stimulating  effects  of  blisters  will  extend  to  deeper 
structures. 

One  other  remedy  in  the  treatment  of  inflammation  is 
counter-irritation,  and  this  is  supposed  to  act  by  producing 
artificial  metastasis,  or  a  removal  of  the  diseased  action  to  less 
important  parts  of  the  body  than  that  originally  affected.  I 
need  not  here  enter  into  a  discussion  of  the  value  of  blisters 
and  other  counter-irritants.  They  are  useful  when  properly 
applied,  and  very  injurious,  especially  in  the  horse,  when  in- 
discriminately used.  Their  beneficial  effects  are  most  apparent 
in  inflammations  of  the  joints,  superficial  fibrous  structures, 
and  in  inflammation,  acute  and  chronic,  of  the  mucous  mem- 
branes. Their  injurious  effects  are  seen  in  acute  inflammations 
of  the  serous  sacs,  of  the  pulmonary  parenchyma,  and  in  exten- 
sive diseases  arising  from  depressing  zymotic  influences. 

"  The  more  intense  forms  of  counter-irritant  treatment  are  so 
painful  that  it  is  well  worth  while  to  be  critical  as  to  their 
value ;  and  it  deserves  more  general  notice  than  it  has  yet 
received,  that  some  of  the  most  accurate  clinical  observers  of  the 
day  are  profoundly  sceptical  on  this  subject.     In  various  cases 


TREATMENT  OF  INFLAMMATION.  75 

of  thoracic  inflammation,  for  instance,  wliere  thousands  of  prac- 
titioners employ  blistering  as  a  matter  of  course,  the  unsurpassed 
authority  of  Professor  Skoda  pronounces  such  treatment  to  be 
always  powerless  for  good,  though  sometimes  powerful  for  harm. 
And  probably  a  large  proportion  of  treatment  by  long-continued 
setons  and  issues  has  subsisted,  less  from  any  sure  knowledge  of 
its  doins:  good,  than  as  a  remnant  of  the  old  belief  that  morbid 
humours  could  thus  be  set  running  from  the  body.  Assuredly 
the  whole  subject  requires  careful  clinical  reconsideration; 
towards  which,  in  this  place,  only  two  suggestions  are  offered. 

"  In  the  first  place,  particularly  with  regard  to  the  uses  of 
blistering,  there  is  a  source  of  fallacy  against  which  the  student 
will  do  well  to  guard  himself.  Not  every  cutaneous  inflamma- 
tion excited  for  surgical  purposes  is  intended  to  be  counter- 
irritant  and  derivative.  There  are  cases  (presently  to  be  again 
adverted  to)  where  it  acts  simply  as  a  further  stimulant  to  the 
part  originally  inflamed.  When,  for  instance,  we  apply  strong 
blistering  fluid  directly  over  a  knee-joint  with  chronic  inflam- 
matory effusion,  the  action  of  the  irritant  propagates  itself,  in 
lessening  degrees,  through  the  intervening  small  thickness  of 
parts,  and  sensibly  affects  the  synovial  surface ;  where  frequently 
at  first  it  causes  some  increase  of  effusion ;  and  where  at  any 
rate  the  desired  removal  of  fluid  only  begins  when  the  super- 
induced excitement  has  begun  to  subside.  And  it  is  by  reason 
of  this  action  that,  with  regard  to  superficial  parts,  blistering, 
if  it  does  not  resolve  the  inflammation,  commonly  determines 
them  to  suppurate ;  a  fact,  sometimes  illustrated  in  the  treat- 
ment of  indolent  inguinal  buboes,  where  it  may  happen  that 
blistering  is  deliberately  used  in  order  to  force  this  alternative 
on  the  part,  and,  either  by  one  way  or  the  other,  to  bring  the 
inflammation  to  a  close. 

"  Similarly,  we  may  sometimes  be  proceeding  rather  too 
drastically  when  we  blister  the  walls  of  the  visceral  cavities.  I 
have  often  seen  cerebral  distress  appear  to  be  much  aggravated 
by  the  application  of  a  blister  to  the  scalp  ;  and  it  has  happened, 
in  making  the  post  mcn^tem  examination  of  a  patient  to  whose 
abdomen  a  blister  had  been  applied,  to  find  on  the  inner  surface 
of  the  abdominal  wall  a  red  patch  (probably  of  more  injected 
muscular  substance  seen  through  the  peritoneum)  corresponding 
to  the  area  of  blistered  skin. 


76  SYMPTOMS  OF  INFLAMMATION. 

"  In  the  second  place,  it  deserves  full  trial  wlietlier  every  in- 
tense and  consequently  painful  form  of  counter-irritation  might 
not  be  superseded  by  the  employment  of  other  means,  less  in- 
tense, but  more  extensively  applied;  whether,  for  instance, 
ten  inches  of  poultice  may  not  be  equivalent  to  three  inches 
of  blister,  or  to  one  inch  of  issue.  For  probably  among  the 
agencies  now  spoken  of  there  is  none  to  which  we  can  look 
with  better  grounded  confidence  than  to  the  diffuse  local  action 
of  warmth,  as  supplied  by  poultices  and  fomentations ;  par- 
ticularly when  it  can  be  so  administered  as  to  affect  a  surface 
of  skin  very  greatly  larger  than  the  quantity  of  inflamed  texture 
which  we  desire  to  relieve. 

"  In  many  chronic — probably  also  in  some  acute — inflamma- 
tions, especially  in  those  which  arise  from  catching  cold,  or 
are  associated  with  gout  or  chronic  rheumatism,  the  excite- 
ment of  the  entire  skin  by  baths  of  hot  air  or  hot  vapour  is 
often  of  the  most  striking  and  immediate  benefit.  And  though 
in  most  of  these  cases  the  result  of  the  exterior  heat  is  probably 
something  more  than  mere  blood-derivation  to  the  skin,  yet  not 
the  less  on  that  account  are  they  important  illustrations  of 
counter-stimulant  treatment. 

"  Pending  the  better  settlement  of  what  is  doubtful  in  the 
present  subject,  there  are  cautions  which  every  one  admits  to 
be  necessary  if  the  counter-irritant  treatment  of  inflammation 
is  to  succeed  according  to  its  intention.  In  proportion,  namely, 
as  the  counter-irritants  which  we  employ  are  of  severe  local 
action,  we  must  take  care — first,  that  they  be  not  so  applied  as 
to  involve  the  inflamed  part  in  their  direct  irritant  operation ; 
and,  secondly,  that  they  be  not  so  apj)lied  as  to  aggravate  any 
existing  febrile  disturbance." — (Simon.) 

TREATMENT  OF  CHEONIC  INFLAMMATION. 

All  depressing  remedies  are  contra-indicated,  and  the  object 
must  be  to  rouse  and  stimulate,  not  only  the  part  diseased,  but 
the  system  generally,  by  good  food,  iron,  quinine  (and  iodates,  if 
there  is  any  dei^osit  or  thickening),  and  by  the  direct  applica- 
tion of  stimulants  to  the  part  itself,  when  superficially  situated. 

It  shoidd  not  be  forgotten,  however,  that  all  mere  remedies 
are  but  of  secondary  consideration  in  the  treatment  of  inflam* 


TREATMENT  OF  CHRONIC  INFLAMMATION.  77 

mation.  The  removal  of  the  cause  is  the  first  essential,  and  after 
this,  absolute  repose  of  the  inflamed  part.  If  these  considera- 
tions are  kept  in  view,  and  the  practitioner  is  aware  that  the 
tendency  of  most  inflammations  is  to  a  favourable  termination, 
he  will  understand  that,  in  many  cases,  the  accidental  symp- 
toms of  urgency  req^uire  treatment,  rather  than  the  disease 
itsel£ 


CHAPTER  IV. 

FRACTURES  AND  DISEASES  OF  BONES. 

CAUSES  OF  FRACTURE SYMPTOMS — MODES  OF  UNION TREATMENT  OP 

FRACTURES — COMPOUND  FRACTURES SEPARATION    OF  EPIPHYSES 

FALSE  JOINTS  AND  NON-UNION. 

A  FRACTURE  is  said  to  occur  in  three  ways : — Isf.  By  external 
violence,  operating  directly  upon  the  injured  part:  2d.  By 
external  violence,  producing  such  concussion  upon  the  bone 
as  not  to  break  it  where  the  force  is  applied,  but  at  some 
other  part:  3d.  By  inordinate  action  of  the  muscles,  as  in 
broken  back.  But  some  bones  are  more  liable  to  fracture  than 
others.  The  bones  of  the  pelvis,  shoulders,  thighs,  pasterns,  legs, 
vertebrae,  and  of  the  face  and  skull,  seem  to  be  more  frequently 
broken  than  the  other  bones  of  the  horse.  In  the  dog,  the 
lea  and  thi^h  bones.  Althouoh  bones  are  fractured  in  animals 
of  aU  ages,  it  is  worthy  of  notice  that  the  bones  of  the  old  are 
more  readily  broken  than  those  of  the  young. 

Bones  are  rendered  liable  to  fracture  from  trivial  causes  by  a 
previously  diseased  condition.  The  navicular  bone,  by  a  peculiar 
atrophy  or  caries.  The  os  pedis,  by  atrophy  and  fragility,  induced 
by  chronic  inflammation ;  and  the  pelvic  bones,  by  a  degenerative 
disease,  partaking  of  the  nature  of  fragilitus  ossium  and  necrosis. 

A  solution  of  continuity  of  bone  (fracture)  may  be  transverse, 
oblique,  or  longitudinal,  according  as  it  is  at  a  right  or  an  acute 
angle  with,  or  parallel  to,  the  long  axis  of  the  part  of  the  bone 
in  which  it  is  situated.  A  fracture  is  said  to  be  simple  when 
a  bone  is  broken  at  one  part,  without  any  injury  of  soft  parts ; 
compound  or  open,  when  there  is  an  open  wound  communicat- 
in<y  with  the  broken  bone ;  comminuted,  when  the  bone  is 
broken   into   several    fragments ;    complicated,  when,  together 


CAUSES  OF  FRACTURE.  79 

with  the  fracture,  there  is  serious  injury  of  the  adjoining 
structures,  as  laceration  of  vessels,  open  joint,  or  serious  con- 
tusion of  the  tissues;  fracture  with  wound,  when  the  wound 
does  not  communicate  with  the  fracture;  impacted,  when  one 
fragment  is  lodged  in  the  other ;  and  partial,  when  the  con- 
tinuity of  only  a  part  of  the  bone  is  broken.  This  last  variety 
has  been  called  by  some  lending,  with  partial  fracture,  and 
by  others  green-stick  fracture.  Bending  may  take  place  with- 
out fracture,  but  this,  as  well  as  bending  with  partial  fracture, 
is  very  rare  in  our  patients,  although  I  have  seen  it  both  in 
dogs  and  young  horses. 


THE  SYMPTOMS  OF  FRACTURE. 

When  fracture  occurs  in  one  or  more  bones  of  a  limb,  the 
symptoms  are — great  lameness  suddenly  manifested,  obvious 
deformity  (with  some  exceptions,  to  be  mentioned),  preternatural 
mobility,  crepitus,  and  inability  to  bear  weight  upon  that  limb. 
These  are  the  general  symptoms;  the  particular  ones,  as  well 
as  the  causes  of  the  several  fractures,  will  be  hereafter  described, 
and  it  will  therefore  be  unnecessary  to  refer  to  them  under  this 
head. 

MODES  OF  UNION. 

The  injury  inflicted  in  a  fracture  is  rarely  limited  to  the  bone. 
The  two  or  more  fragments,  driven  in  opposite  directions,  pene- 
trate and  wound  the  adjacent  tissues,  giving  rise  to  more  or  less 
less  hsemorrhage.  If  the  skin  is  broken,  suppuration  generally 
foUows,  and  the  repair  is  attended  with  difficulty ;  but  if  the 
injuries  are  subcutaneous,  and  the  air  has  no  access  to  the 
damaged  part,  the  repair  is  more  easily  effected. 

The  extravasation  of  blood  about  fractures  is  not  only  uncer- 
tain in  amount,  but  unequal  in  the  several  tissues.  Its  presence 
is  useful  for  diagnosis,  particularly  in  the  diagnosis  of  fracture  of 
the  humerus. 

A  ridiculous  idea  has  prevailed  amongst  horsemen,  that 
fi^actured  bones  in  the  horse  never  unite.  This  is  incorrect, 
and,  owing  to  the  same  tendency  that  produces  splints,  spavins, 
&c.,  the  process  of  union  and  repair  is  a  very  rapid  and  efficient 
one,  provided  the  solution  of  continuity  does  not  extend  into  a 


80 


FRACTURES  AND  DISEASES  OF  BONES. 


joint  having  extensive  motion,  and  that  the  frachired  ends  can  be 

kept  at  rest. 

An  early  consequence  of  fracture  appears  to  be  an  exudation 

of  lymph,  which  is  at  first  dimly  granular,  but  becomes,  at  a 

later  period,  ruddy,  elastic,  or  moderately  firm  and  succulent. 

It  soon  attains  firmness,  when  it  is  called  a  callus. 

There  are  two  methods  according  to  which  the  callus  may 

be  placed.  In  one  method  the  broken 
ends  or  smaller  fragments  of  bone 
are  completely  enclosed  in  a  new 
material ;  they  are  ensheathed  or  held 
together  by  it,  as  two  portions  of  a  rod 
might  be  by  a  ring  fastened  round  them 
both. 

The  new  material,  in  such  a  case, 
surroundim?  the  fracture  is  termed 
"  provisional,"  "  external,"  or  "  en- 
sheathing"  callus. 

In  the  other  method  the  new  mate- 
rial is  only  placed  between  those 
parts  of  the  broken  bone  whose  sur- 
faces are  opposed ;  between  these,  it 
is  inlaid,  filling  the  space  that  would 
else  exist  between  them,  and  uniting 
them  by  being  fixed  to  both  (like 
the  process  of  gluing  two  pieces  of 
wood).  Eeparative  material  thus 
placed  has  been  called  intermediate 
callus.  In  either  method,  tliere  is 
usually  some  reparative  material  de- 
posited in  and  near  the  medullary 
tissue,  and  this  is  called  interior 
callus. 

In  fractures  that  occur  in  the  lower 
animals,  with  the  exception  of  those 
Fig.  9.— Oblique  fracture  of  found   in   the   fixed    bones,  the   en- 

tae  tibia,  with  external  (ensheath-  ...  ^       . 

irig)  callus,  marked  a  and  b.    The  sheathmg  calhlS  IS  USUal. 

Hne  extending  from  a  indicates         j^j,^^^^    ^|^q     researches      of     Hallcr, 

the  seat  of  the  fracture,  the  new  , 

deposit  (callus)  being  purposely  Duhamcl,  Huntcr,  Dupuytrcn,  raget, 
^^°^°^^^-  and  Stanley,  we  find  that  nature  never 


MODES  OF  UNION. 


81 


accomplishes  the  union  of  a  fracture  without  tvjo  successive  de- 
posits of  callus,  and  Dupuytren  arranged  the  phenomena,  from 
the  time  of  fracture  to  the  exact  and  complete  reunion,  into  five 
different  periods. 

In  the  first  stage,  comprehending  a  period  of  eight  or  ten  days, 
blood  is  extravasated  into  the  medullary  canal  between  the 
fragments,  and  under  the  periosteum,  raising  up  the  latter  from 
the  bone  for  some  distance  above  and  below  the  fracture ;  the 
medullary  membrane  becomes  swollen  and  separated  from  the 
bone,  and  the  periosteum  is  not  only  raised  from  the  bone,  but 
also  becomes  red,  soft,  swollen,  and  preternaturally  vascular. 
The  fragments  of  bone  may  thus  be 
said  to  be  surrounded  with  blood, 
which  not  only  fills  the  medullary 
canal  and  space  between  the  frag- 
ments, but  also  separates  the  latter 
from  the  detached  periosteum.  This 
blood  may  be  organized  or  become 
absorbed,  and  liquor  sanguinis  effused 
into  the  parts  at  first  occupied  by  it. 

In  the  second  stage,  comprising  the 
interval  between  the  tenth  or  twelfth 
to  the  twentieth  or  twenty-fifth  day, 
the  "  tumour  of  callus,"  as  it  is  called 
by  Dupuytren,  is  formed.  The  sub- 
stance between  the  periosteum  and 
bone  is  converted  into  a  structure 
like  fibro-cartilage,  and  within  the 
medullary  canal  there  is  also  deve- 
loped a  fibro-cartilage,  but  the  sub- 
stance between  the  fragments  retains 
the  appearance  of  coagulable  lymph. 

In  the  third  stage,  extending  from 
the  twentieth  or  twenty -fifth  day  to 
the  thirtieth,  fortieth,  or  sixtieth  day,  ,  ^^f-  10. --Fracture  of  meta- 

•^  '    tarsal,   showing  the  plug  within 
according    to    age     and    strength,    the    the  medullary  canal     The  plug 

fibro-cartilage  between  the  periosteum  ^^  ossified. 
and  bone,  and  that  within  the  medullary  canal,  are  both  con- 
verted into  bone,  the  external  forming  a  ring,  ferrule,  or  clasp  ; 
and  the  internal  a  plug,  or  peg,  filling  up  the  medullary  canal, 

G 


82  FKACTURES  AND  I^SEASES  OF  BONES. 

and  together  constituting  the  provisional  callus.  The  external 
ring,  embracing  both  fragments,  and  the  plug,  within  the 
medullary  canal,  constitute  nature's  provision  for  keeping  the 
fragments  in  apposition  and  at  rest.  The  substance  between  the 
fragments  is,  during  this  stage,  changed  into  fibro-cartilage. 

In  the  fourth  stage,  extending  to  the  fifth  or  sixth  month,  it 
is  converted  into  bone,  constituting  the  permanent  or  definitive 
callus. 

In  the  fifth  stage,  extending  from  the  fifth  or  sixth  month  to 
the  tenth  or  twelfth,  the  provisional  callus,  being  no  longer 
necessary,  disappears,  and  the  medullary  canal  is  restored. 
Such  are  the  views  of  Dupuytren ;  and  such  is  the  method  by 
which  fractures  are  repaired  in  the  lower  animals.  The  only 
exceptions  which  I  have  observed,  have  been  the  union  of 
fractures  of  the  lower  maxillary  bone,  when  the  fracture  has 
been  longitudinal,  and  bound  so  firmly  as  to  admit  of  no  motion 
whatever  between  the  fragments.  Doubtless,  the  fractures  of 
our  patients  would  unite,  as  those  of  the  bones  of  the  human 
being,  by  the  reparative  material  being  thrown  out  between  the 
broken  ends — that  is,  by  intermediate  or  permanent  callus — pro- 
vided the  parts  could  be  kept  in  a  state  of  complete  repose ;  but 
this  being  impossible,  nature  has  provided  a  method  by  which 
they  are  held  in  a  state  of  quietude,  until  the  permanent  callus 
is  finally  deposited  between  the  broken  fragments. 

The  latter  part  of  the  process  of  repair  is  that  of  the  shaping 
and  the  modelling  of  the  fragments  and  their  bond  of  union. 
These  consist  of — (1.)  The  removal  of  sharp  projecting  points 
and  edges  from  the  fragments ;  (2.)  The  closing  or  covering  of 
the  exposed  ends  of  the  medullary  tissue ;  (3.)  The  formation 
of  a  compact  external  wall  and  cancellous  interior  for  the  new 
bone ;  and  (4.)  The  making  of  these  continuous  with  the  walls 
and  cancellous  tissue  of  the  fragments.  The  first  is  effected  by 
the  absorption  of  the  offending  points  and  angles,  and  in  the 
absorption  of  bone  the  earthy  matters  are  first  removed.  The 
closing  or  covering  of  the  parts  of  the  broken  medullary  tube, 
which  are  exposed  in  fractures  with  much  displacement,  is 
slowly  accomplished  by  the  formation  of  a  thin  layer  of  com- 
pact tissue  similar  to  that  which  covers  the  cancellous  tissue  at 
the  articular  ends  of  bones. 

The  callus,  before  ossifying,  may  become,  according  to  Paget, 


MODES  OF  UNION.  83 

either  fibrous  or  cartilaginous,  or  may  assume  a  structure  inter- 
mediate between  these,  and  in  any  of  these  cases  ossification  may 
ensue.  In  different  specimens,  or  sometimes  in  different  parts 
of  the  same,  the  reparative  material  has  in  one  displayed  fibrous 
tissue  with  a  few  imbedded  corpuscles,  like  the  large,  nearly 
round,  nuclei  of  cartilage  cells ;  in  another,  a  less  appearance  of 
fibrous  structure,  with  more  abundant  nucleated  cells,  havimr 
all  the  characters  of  true  cartilage  cells ;  and  in  another,  a  yet 
more  nearly  perfect  cartilage.  Through  any  of  these  structures 
the  reparative  new  bone  may  be  formed.  It  may  be  formed, 
first,  where  the  reparative  material  is  in  contact  with  the  old 
bone,  and  thence  extending,  it  may  seem  as  if  it  grew  from  the 
old  bone ;  it  may  be  also  formed  in  the  new  material  in  detached 
centres  of  ossification,  from  which  it  may  extend  through  the 
intervening  tissues,  and  connect  itself  with  the  old  bone. 

The  new  bone,  by  whatever  mode  it  is  formed,  appears  to 
acquire  its  proper  microscopic  characters.  Its  corpuscles,  or 
lacunae,  at  first  simple,  round,  or  oval  shaped,  become  jagged 
at  their  edges,  and  subsequently  acquire  their  canals,  which 
appear  to  be  hollowed  out  in  the  pre-formed  bone  as  minute 
channels  communicating  with  one  or  more  of  the  lacunae.  The 
laminated  canals  for  blood-vessels  are  later  formed.  At  first,  all 
the  new  bone  forms  a  minutely  cancellous  structure,  which  is 
light,  spongy,  soft,  and  succulent,  with  a  reddish  juice,  rather 
than  marrow ;  and  is  altogether  like  the  bones  of  the  foetus  at 
their  first  construction.  But  it  gradually  assimilates  itself 
to  the  structure  of  the  bones  that  it  repairs,  its  outer  portions 
assuming  a  compact  laminated  structure,  and  its  inner  acquiring 
wdder  cancellous  spaces  and  a  more  perfect  medulla.  It  acquires 
a  definite  periosteum,  which  is  at  first  thin  and  lamellar,  but 
gradually  assumes  toughness  and  compactness. 

Eepair  of  fracture  by  formation  of  a  false  joint  is  an  arrest- 
ment of  the  process  before  ossification  has  commenced. 


TREATMENT  OF  FRACTURES. 

In  the  treatment  of  a  fracture,  it  is  of  great  consequence  to 
perform  reduction  as  soon  as  possible  after  the  injury  is  sus- 
tained, in  order  to  prevent  the  bad  effects  of  continued  irrita- 
tion, and  before  the  occurrence  of  sw^elling  and  thickening  of  tlie 


84  FRACTURES  AND  DISEASES  OF  BONES. 

parts  which  surround  the  broken  bones-  can  prove  an  impedi- 
ment to  their  proper  adjustment.  When  swelling  and  tension 
are  actually  present,  no  time  should  be  lost  in  vain  attempts  to 
allay  these  by  means  of  fomentations,  &c.,  but  the  practitioner 
must  at  once  reduce  the  fracture — the  horse  being  first  placed 
in  sKngs  (see  Frontispiece) — and  place  the  limb  in  a  steady  and 
fixed  position  by  means  of  splints  and  bandages.  The  source  of 
irritation  being  thus  removed,  the  swelling  will  soon  disappear. 
The  best  material  for  splints  is  strong  leather,  what  is  called 
"  bend-leather,"  the  pieces  being  made  sufficiently  long  to  extend 
to  a  distance  beyond  the  fractured  ends  of  the  bones,  and  broad 
enough  to  envelop  and  enclose  the  whole  circumference  of  the 
limb.  Holes  may  be  cut  in  the  leather  where  the  splints  pass 
over  any  sharp  eminence,  as,  for  example,  over  the  trapezium 
in  the  knee.  Gutta-percha  is  recommended  by  some  prac- 
titioners, and  it  answers  very  well,  but  I  prefer  the  strong 
leather.  Before  it  is  applied,  it  should  be  well  soaked  in  warm 
water ;  when  thus  softened,  it  may  be  moulded  to  the  shape  of 
the  limb  with  the  greatest  ease.  The  splints  are  to  be  retained 
in  their  position  by  bandages.  When  swelling  and  tension  are 
present  before  the  fracture  is  reduced,  the  splints  may  be  main- 
tained in  position  by  the  looped  bandage;  which  consists  of 
strips  of  calico,  about  two  or  three  inches  broad,  and  long  enough 
when  folded  double  to  pass  round  the  limb,  with  a  few  inches 
of  excess;  one  of  the  ends  is  then  drawn  through  the  loop, 
and  tied  to  the  other.  This  bandage  is  useful  when  the 
degree  of  tightness  requires  to  be  altered,  but  it  must  be 
replaced  by  the  common  roller,  as  soon  as  the  swelling  has 
subsided,  and  supplemented  by  one  or  two  layers  of  bandages 
saturated  with  starch,  dextrine — or  what  answers  the  purpose 
equally  well,  and  is  much  cheaper — flour  paste,  made  by  boihng 
flour  in  water.  When  dry,  the  bandages  become  immoveable, 
and  support  the  limb  so  effectually,  that  the  animal  soon 
puts  weight  upon  it.  In  using  the  starch  bandage,  great  care 
is  requisite  in  its  adjustment:  it  must  not  press  unequally 
upon  any  part  of  the  limb,  all  hollows  are  to  be  padded  with 
tow,  and  it  must  never  project  beyond  the  extremities  of  the 
dry  bandages;  or  its  edges,  becoming  hardened,  may  cut 
and  wound  the  skin,  causing  irritation  and  pain ;  rendering 
the  patient  uneasy,  feverish,  and  the  limb   liable  to  mortifi- 


.'•   TREATMENT  OF  FRACTURES.  85 

cation  by  the  swelling  so  produced.  Another  method  of 
"bandaging  is  by  the  careful  application  of  tarred  cord  to  the 
whole  limb  over  the  leather,  the  cord  commonly  used  for  thatch- 
ing stacks  answering  every  purpose.  The  animal,  if  a  horse,  is 
to  be  kept  in  a  state  of  quietude  in  the  slings  for  a  period  vary- 
ing from  two  to  three  months.  In  foals  and  young  unbroken 
horses,  the  slings  must  be  dispensed  with,  and  it  is  wonderful  to 
see  how  carefully  an  animal, — gay  and  spirited,  perhaps,  before  the 
accident, — will  nurse  the  broken  limb ;  for  such,  in  addition  to 
sphnts,  bandages,  &c.,  a  comfortable  loose  place,  bedded  with  saw- 
dust, chaff,  or  short  straw,  is  all  that  is  necessary.  When  the  bones 
of  horned  cattle  are  fractured,  they  must  be  treated  exactly  in  the 
same  manner  as  those  of  the  young  horse,  slings  being  as  a  rule 
inadmissible.  The  limbs  of  dogs  when  broken  require  nothing  but 
the  starch  bandage,  and  in  the  course  of  a  very  few  weeks  they 
will  be  found  completely  recovered.  Such,  then,  are  the  general 
principles  whereby  fractures  are  to  be  treated.  I  have  had  expe- 
rience in  the  use  of  the  plaster  of  Paris  (sulphate  of  lime)  treat- 
ment, but  I  cannot  recommend  it,  as  it  is  liable  to  crack  and  fall 
asunder ;  but  Mr.  Broad  of  Bath,  and  Mr.  R.  Spooner  Hart  of  Cal- 
cutta, recommend  the  plaster  of  Paris  bandage,  and  state  that,  if 
properly  adjusted,  it  forms  the  best  material  for  retaining 
fractured  bones  in  proper  position.  It  is  applied  as  follows : — 
Cut  thin  calico  into  narrow  slips,  mix  the  gypsum  with  cold  water 
to  a  consistence  thicker  than  cream ;  the  bandage  is  then  to  be 
soaked  in  it,  rolled  up  quickly,  and  bound  round  the  leg,  but  not 
too  tightly,  the  animal  to  be  kept  still  for  a  few  minutes  to  enable 
the  plaster  to  set  firmly.  To  prevent  dogs  from  biting  it  off,  Mr. 
Broad  recommends  that  the  bandage  be  sprinkled,  before  it 
sets,  with  cayenne  pepper.  Splints  made  of  block-tin  form  a 
very  convenient  apparatus  for  retaining  fractured  bones  in  their 
proper  position.  They  are  easily  made  to  the  shape  and  form  of 
any  part  of  the  limb,  are  light,  easily  applied,  and  retained  in 
position  by  bandages.  They  should  be  rounded  at  their  edges, 
and  all  spaces  between  them  and  the  irregularities  of  the  limb 
padded  with  tow.  Mr.  Robinson,  Y.S.,  Greenock,  was  the  first 
to  suggest  the  idea  to  me.  He  finds  them  useful  in  broken  knees, 
and  other  injuries  where  suppression  of  motion  is  desirable. 

An  animal  may  be  lame  for  some  weeks  or  months  after 
a  fracture    has    united     but  if   no    articulation   is   involved 


S6  FRACTURES  AKD  DISEASES  OF  BONES. 

recovery  will  gradually  become  complete.  Some  practitioners 
fire  their  patients  for  the  removal  of  such  lameness ;  such  prac- 
tice cannot  be  too  highly  condemned.  It  is  useless,  nay,  mis- 
chievous and  cruel.  I  wonder  what  would  be  said  of  a  surgeon 
who  fired  for  a  broken  leg !    The  thing  is  absurd. 


COMPOUND  FRACTURES. 

By  this  term  is  meant  a  fracture  having  communication  with 
the  external  air  by  means  of  a  wound,  which  is  produced  at 
once  by  the  same  cause  as  that  which  gave  rise  to  the  fracture : 
or  afterwards  by  one  or  more  fragments  being  forced  through  the 
skin,  or  at  a  more  remote  period  by  sloughing  and  ulceration  of 
the  surrounding  soft  parts.  This  wound  makes  a  most  important 
difference  in  respect  of  the  danger  and  difficulty  of  cure.  There 
is  apt  to  arise  from  this  source  violent  inflammation  and  fever, 
terminating  in  profuse  suppuration  or  gangrene.  The  object  in 
treating  such  is  to  obtain  immediate  union  of  the  wound,  and 
thus  convert  a  compound  fracture  into  a  simple  one.  There 
are  many  cases  on  record  of  a  successful  issue  being  obtained 
from  the  treatment  of  compound  fracture  in  the  horse ;  but  in 
the  majority  of  cases  the  terminations  ar^  very  unfavourable. 
If  the  bone  projects  through  the  wound,  and  cannot  be  returned, 
unless  in  the  case  of  a  valuable  stud  animal,  the  patient  had 
better  be  destroyed ;  but  if  treatment  be  determined  upon,  the 
first  consideration  is  the  reduction  of  the  fracture ;  this  may  be 
done  by  extension  and  counter-extension,  aided  by  proper  mani- 
pulation. If  the  fracture  be  transverse,  these  means  will  be 
successful;  but  if  it  be  oblique,  it  may  become  advisable  to 
enlarge  the  wound,  to  admit  of  the  replacement  of  the  frag- 
ments. In  some  cases,  replacement  cannot  be  effected  without 
removing  the  sharp  ends  of  the  protruding  bone  wdth  a  saw  or 
bone  forceps.  When  the  fracture  is  reduced,  the  edges  of  the 
wound  should  be  carefuUy  brought  together,  and  kept  in  close 
approximation  by  means  of  plaster,  styptic  colloid,  or  other 
adhesive  substance. 

After  the  use  of  these  means,  every  endeavour  should  be 
made  to  moderate  inflammatory  action,  prevent  suppuration,  by 
carbolic  acid,  or  other  antiseptic  dressing  to  the  wound,  and 
to  lessen  febrile  disturbance.     In  our  patients  means  must  be 


COMPOUND  FRACTURES.  87 

used  to  keep  the  fractured  ends  in  their  proper  position,  and 
splints  must  be  applied.  An  aperture  must  be  made  in  that 
portion  of  the  splint  covering  the  wound,  so  as  to  render  its 
removal  unnecessary  during  dressing,  and  to  allow  the  escape  of 
any  discharge  which  may  occur.  By  these  means  a  compound 
fracture  may  be  changed  into  a  simple  one — the  wound  uniting 
by  adhesion.  The  constitutional  disturbance  must  be  mitigated 
by  attention  to  the  bowels  (a  small  dose  of  physic  may  be 
given),  by  allowing  the  lightest  possible  diet,  and  by  allay- 
ing the  pain,  if  extreme,  by  opium ;  every  unnecessary  move- 
ment being  at  the  same  time  avoided.  When  immediate  union  of 
the  wound  is  not  obtained,  the  practitioner  need  not  despair, 
provided  the  constitutional  irritation  and  pain  be  not  extreme, 
nor  the  discharge  from  the  wound  excessive.  When  suppura- 
tion from  the  wound  has  taken  place,  the  parts  are  to  be 
bathed  with  tepid  water,  and  the  bandage  over  the  wound 
kept  constantly  wet  by  the  process  of  irrigation,  to  be  described 
hereafter.  No  pus  should  be  allowed  to  remain  about  the 
wound.  All  soiled  dressings  must  be  avoided;  the  weak  car- 
bolic acid  solution  must  be  applied  frequently ;  and  in  some 
cases  it  will  be  requisite  to  syringe  any  pus-containing  cavities 
with  this  remedy.  The  animal's  strength  must  now  be  kept 
up  by  generous  food ;  the  stable  or  box  kept  sweet  and 
well  ventilated.  If  due  attention  be  paid  in  all  these  re- 
spects, a  recovery  may  be  the  reward.  But  too  commonly 
unpropitious  symptoms  arise  about  the  third  day  after  the 
accident ;  the  limb  swells  considerably ;  the  discharge  becomes 
profuse,  thin,  sanious,  and  foetid;  there  is  great  pain  mani- 
fested; the  fever  runs  high,  the  breathing  hurried;  the  pulse 
is  quick,  and  the  appetite  lost.  In  such  a  case  an  unsuccessful 
termination  may  be  looked  for,  and  it  is  better  to  anticipate  it, 
and  save  the  poor  animal  mach  suffering,  by  ordering  its  de- 
struction. In  horned  cattle  and  dogs  amputation  has  been 
performed,  and  the  animals  have  gone  about  on  three  legs 
afterwards.  I  remember  seeing  a  cow  in  a  drove  en  route 
to  London  from  Wales  with  a  wooden  leg,  amputation  having 
been  performed  above  the  knee. 


SEPARATION  OF  THE  EPIPHYSES. 

Before  the  epiphyses  are  ossified  to  their  shafts,  they  are  apt 


88  FRACTUKES  AND  DISEASES  OF  BONES. 

to  suffer  separation  from  them  by  such  accidents  or  violence  as 
would — later  in  the  animal's  life,  and  when  the  process  of  ossifi- 
cation had  become  complete — occasion  fracture.  The  symp- 
toms and  treatment  are  the  same  as  those  of  fracture. 


FALSE  JOINTS  AND  NON-UNION. 

Fractured  bones  sometimes  do  not  unite  firmly  together,  their 
extremities  remain  quite  detached,  or  are  merely  connected  by  a 
fibro-cartilagjinous  structure. 

The  constitutional  causes  so  common  in  man  do  not,  as  a 
rule,  aj^ply  to  the  lower  animals,  but  occasionally  it  is  found 
that  a  condition  of  the  osseus  system,  termed  mollities  ossium, 
and  another  partaking  of  the  nature  of  necrosis,  exist,  and  effec- 
tually prevent  reunion  of  the  bones.  The  most  common  cause 
of  false  joint  is  the  want  of,  or  the  impossibility  of  securing, 
proper  apposition  of  the  fractured  ends ;  and  its  most  frequent 
situation,  the  anterior  spinous  process  of  the  ileum.  Indeed, 
it  can  be  safely  said  that  this  fracture  always  ends  in  a  false 
joint.  When  broken,  the  legs  of  dogs  are  sometimes  united 
in  this  way,  even  after  every  precaution  has  been  taken  to 
secure  all  the  essentials  of  recovery.  This  termination  of  the 
healing  process  may  be  looked  upon  as  an  example  of  arrested 
development  of  the  reparative  material ;  every  part  of  the  pro- 
cess of  repair  being  complete  except  that  of  ossification;  the 
fragments  being  held  together  by  a  yielding  and  pliant  band. 

In  order  to  secure  perfect  reunion  of  the  fractured  ends  of 
bones,  it  is  necessary — (1st.)  That  little  or  no  motion  should  exist 
between  them :  (2d.)  That  there  be  no  excess  of  inflammatory 
action :  (3d.)  That  there  be  no  interposition  of  pieces  of  muscle, 
tendon,  or  necrosed  bone  between  the  fragments;  and  (4:th.) 
That  there  be  a  proper  supply  of  blood  to  the  part.  Curling, 
Guerton,  and  others  have  paid  attention  to  this  subject,  and 
have  shown  that  non-union,  as  well  as  atrophy  of  bone,  may  be 
due  to  defective  supply  of  blood,  caused  by  rupture  of  the 
nutrient  artery  of  the  broken  bone. 

It  is  found  that  if  the  supply  of  blood  be  cut  off  by  injury 
to  the  nutrient  artery,  so  tliat  the  periosteum  has  exclusively 
to  supply  the  blood,  either  one  or  both  of  the  fractured 
pieces  become  atrophied,  and  their  cancellated  structure  and 
walls   thinned.      While  writing  this   paper,  I   had   an  oppor- 


FALSE  JOINTS  AND  NON-UNION.  89 

tunity  of  seeing  a  case  of  non-union  of  the  pelvic  bones  in  a 
healthy  animal.  The  bones  were  in  apposition,  the  fracture 
being  an  oblique  one  through  the  shaft  and  spine  of  the  ileum. 
Two  months  after  the  accident,  the  bones  were  moveable  and 
crepitant ;  there  were  no  inflammatory  signs  nor  pain  present, 
the  animal  being  in  the  best  of  health  and  spirits,  but  lame. 

Treatment. — An  ingenious  method  is  recommended  by  Mr. 
Syme : — "  This  method  was  devised  by  Dr.  Physick,  of  New 
York,  in  1804;  and  it  consists  in  passing  a  skein  of  silk  or 
cotton  between  the  extremities  of  the  bone,  and  allowing  it  to 
remain  until  it  appears  that  new  bone  begins  to  be  formed, 
when  it  may  be  withdrawn  and  splints  applied."  Another  plan 
consists  in  drilling  holes  in  the  fragments  with  the  ordinary 
Archimedean  drill,  and  fixing  them  in  apposition  by  ivory  pegs 
driven  into  the  drilled  holes.  I  think  this  method  deserving  of 
trial  in  compound  fractures,  even  in  the  earlier  stages.  The 
pegs  must  not  project  from  the  surface  of  the  bones,  but  must 
be  cut  off  level,  so  that  they  do  not  wound  the  soft  structures. 

Blisters  over  the  seat  of  fracture  may  be  tried.  They  may, 
by  causing  the  production  of  a  fibrinous  exudate,  set  up  the 
healing  process,  which  may  ultimately  end  in  complete  con- 
solidation of  the  disunited  fragments. 

One  more  method  may  be  mentioned,  namely,  that  recom- 
mended by  Miller.  It  consists  in  introducing  a  long  needle 
through  the  skin,  passing  it  into  the  false  joint,  and  cutting 
up  the  ligamentous  bond  of  union,  as  well  as  the  self-investing 
tissues  on  the  bones ;  covering  the  opening  with  collodion  and 
plaster,  and  keeping  the  fragments  at  rest. 

Tliere  is  great  danger  in  allowing  an  animal  to  use  his 
limb  too  freely  soon  after  the  apparent  union  of  a  fracture ;  as 
gradual  yielding  of  the  bone  may  take  place,  and  deformity 
occur  from  the  weight  thus  thrown  upon  the  limb ;  hence  the 
starch  bandage  should  be  retained  for  a  considerable  time,  and 
the  animal  kept  in  a  box  for  three  or  four  weeks  after  his 
removal  from  the  slings.  The  loose  box  will  be  better  than 
the  stall,  as  the  animal  will  be  able  to  take  some  little  exercise, 
and  thus  allow,  as  it  were,  of  passive  movements  of  the  limb, 
wdiich  will  prevent  thickening,  or  adhesion  of  the  tendons  to 
their  thecse. 

When  a  fracture  fails  to  unite,  the  causes  of  such  non- 
union may  be  looked  for  in  a  variety  of  circumstances  ;  but  the 


90  FRACTURES  AND  DISEASES  OF  BONES. 

most  common  of  these,  in  the  lower  animals,  is  the  inability 
to  prevent  motion  in  the  limb.  Temperament  has  much  to 
do  with  this.  A  calm,  good-tempered  horse  may  make  a 
good  recovery,  whilst  an  irritable,  fretful  animal  will  keep  an 
injured  limb  in  a  state  of  continual  motion,  will  take  un- 
kindly to  the  slings,  and  thus  render  union  an  impossibility. 
In  addition  to  or  independently  of  this  want  of  repose,  even 
in  a  simple  fracture,  a  piece  of  muscle  or  other  soft  tissue 
may  be  imprisoned  between  the  broken  ends  of  the  bones, 
and  if  this  is  not  removed,  union  is  not  likely  to  take 
place.  When  a  fracture  is  oblique,  this  complication  is  not 
at  all  uncommon. 

When  a  fracture  is  comminuted,  and  a  large  portion  of  bone 
denuded  of  its  periosteum,  it  can  be  easily  seen  why  union  does 
not  take  place.  Necrosis  of  the  fragments  will  be  almost  sure 
to  occur,  leading  on  to  suppuration,  loss  of  substance,  and  the 
exhaustion  of  the  patient. 

Again,  if  the  violence  causing  the  fracture  be  very  great  in- 
deed, the  vitality  of  the  surrounding  textures  may  be  destroyed, 
or  the  non-union  may  proceed  from  impaired  vitality  of  the 
bone  itself;  and  this  may  arise  from  the  nutritious  artery  of  the 
bone  being  implicated.  In  such  a  case,  union  of  the  deep-seated 
parts  of  the  fracture  would  be  very  improbable. 

Surrounding  circumstances  and  food  have  an  effect  upon  the 
repair  of  fractures.  Where  stables  are  overcrowded  and  ill 
ventilated,  necrosis  and  suppuration  will  most  likely  occur ;  and 
if  these  be  associated  with  improper  food,  it  will  be  useless  for 
the  practitioner  to  undertake  the  treatment. 

I  have  seen  cases  where  union  of  the  pelvis  did  not  com- 
mence until  the  food  had  been  changed.  If  it  be  possible  to 
give  green  food,  it  should  always  have  a  preference  over  all 
other;  failing  this,  carrots,  potatoes,  or  turnips  should  be  allowed, 
in  addition  to  hay  and  corn. 

The  constitutional  causes  of  non-union  are  those  of  a  de- 
bilitating nature,  arising  from  old  age,  hard  usage,  or  disease. 
If  a  great  number  of  horses  are  stabled  together,  no  matter  how 
good  the  ventilation,  drainage,  food,  &c.,  may  be,  a  peculiar  taint 
is  often  produced  upon  their  constitutions  by  an  animal  malaria, 
causing  a  cachexia,  or  condition  of  body  in  which  the  reparative 
powers  are  in  a  depressed  and  languid  condition ;  in  such  the 
repair  of  fractures  is  effected  with  difiiculty. 


CHAPTER  V. 

PARTICULAR  TRACTURES. 

FHACTURES  of  inferior  maxilla FRACTURES  OF  ANTERIOR  MAXILLA 

AND    OF    OTHER    FACIAL    BONES FRACTURES    OF    CRANIAL    BONES 

FRACTURE  BY  "  COUNTER  STROKE" CONCUSSION  OF  THE  BRAIN 

HERNIA  CEREBRI, 

FRACTURES  OF  THE  INFERIOR  MAXILLARY  BONE. 

1st  Compound  fracture  through  the  symphysis  maxillaris, 
resulting  from  an  animal  falling  upon  the  mouth.  The  direction 
of  the  fracture  is  longitudinal,  involving  the  alveolar  cavities  of 
one  or  more  incisor  teeth,  and  extending  through  and  termina- 
ting in  the  maxillary  space ;  or  obliquely,  from  the  centre  out- 
wards, through  the  neck  of  one  or  both  rami. 

Treatment — Fracture  through  the  Symphysis. — Eemove  loose 
teeth  and  foreign  bodies ;  search  for  any  loose  pieces  of  bone, 
and  remove  them.  When  this  is  done,  it  will  be  found  that 
the  fragments  can  easily  be  brought  into  apposition  by  a  little 
pressure,  and  so  maintained  by  means  of  copper  wire  bound 
firmly  round  the  incisor  teeth.  If  the  animal  be  a  male,  the 
tushes  may  be  included  in  the  wire.  A  calico  bandage  may 
then  be  applied,  for  the  purpose  of  further  strengthening  the 
parts,  and  keeping  out  foreign  bodies  from  the  wound.  Let 
the  animal  be  kept  upon  soft  but  nutritious  food ;  the  wound 
looked  to  occasionally,  and  washed  out  with  a  solution  of  carbolic 
acid  to  destroy  the  foetor  which  is  sure  to  be  present.  In  the 
course  of  three  or  four  weeks  the  fracture  will  be  found  re- 
united. 

If  the  practitioner  suspects  that  any  necrosed  portion  of  bone 
exists  in  the  wound,  he  must  search  for  and  remove  it.  Its 
presence  may  be  suspected  by  a  foetid,  purulent,  sanious  dis- 


92  PARTICULAR  FRACTURES. 

charge  taking  place  from  the  wound,  and  by  the  animal  not 
making  that  progress  towards  recovery  which  he  has  a  right  to 
expect. 

2d.  Superficial  fractures  of  the  lower  jaw  occur  from  severe 
curbs  and  bits ;  anteriorly  and  within  the  mouth  from  the  bit, 
posteriorly  and  under  the  jaw  from  the  curb. 

Symptoms  from  Injury  of  the  Bit. — Dribbling  of  saliva  from, 
or  foaming  in,  the  mouth ;  the  animal  shy  or  perhaps  vicious  if 
the  mouth  is  touched ;  inability  to  bear  the  introduction  of  the 
bit ;  difficulty  in  masticating  food ;  perhaps  haemorrhage  from 
the  mouth,  or  saliva  streaked  with  blood.  Upon  examination, 
the  buccal  membrane  will  be  found  bruised,  inflamed,  and 
swollen,  with  perhaps  a  piece  of  bone  sticking  through  it. 

Treatment. — Eemove  the  small  fragments.  As  the  fracture  is 
superficial,  no  bandaging  is  required  ;  but  the  animal  must  not 
be  bitted  until  the  parts  are  completely  healed  and  hardened, 
or  he  will  have  a  bad  or  weak  mouth  ever  afterwards ;  indeed, 
some  horses  that  I  have  seen  never  allow  a  bit  to  be  put  into 
tlieir  mouths  again  without  great  struggling  and  resistance. 
The  animal  should  be  fed  upon  soft  diet  for  some  days  after 
the  injury,  and  the  wound  examined  occasionally,  as  portions 
of  bran,  hay,  or  corn  are  apt  to  lodge  in  it,  causing  irritation, 
and  retarding  the  healing  process.  If  the  wound  discharge 
a  foetid  material,  it  should  be  s}T?inged  with  a  weak  solution  of 
carbolic  acid ;  in  any  case,  the  mouth  may  be  washed  with  this 
two  or  three  times  a  day. 

Symptoms  from  Fracture  hy  the  Curb. — Swelling  and  tender- 
ness of  either  ramus  immediately  in  front  of  the  curb ;  sinuses 
shortly  form,  and  within  them  loose  pieces  of  necrosed  bone 
may  be  detected  by  the  probe.  The  discharge  is  curdled, 
foetid,  but  not  very  profuse.  In  some  of  these  cases  there  is 
no  primary  fracture,  but  necrosis  of  the  superficial  layer  of  the 
bony  tissue,  arising  from  continued  and  severe  pressure,  pro- 
ducing periostitis,  gangrene  of  the  periosteum,  and  death  of  the 
bone,  from  the  pressure,  and  non-supply  of  blood  to  that  part  of 
it  covered  by  the  gangrenous  periosteum.  In  other  cases  a  bony 
tumour  forms  here  as  a  result  of  periostitis,  and  of  increased 
thickness  of  tlie  superficial  layer  of  the  bone  (hyperostosis).  In 
the  first  and  second  forms  of  injury,  it  is  necessary  to  remove 
the  fragments  of  bone,  whether  they  are  necrosed  or  not.     It  is 


FRACTURES  OF  THE  FACIAL  BONES.  93. 

waste  of  time  to  allow  them  to  be  removed  by  exfoliation. 
The  method  which  I  recommend,  is  to  slit  up  the  skin,  and 
carefully  scrape  the  diseased  surface.  If  this  be  done,  the  cure 
may  be  effected  in  a  very  short  time.  If  the  necrosis  is  very 
superficial,  one  or  two  applications  of  dilute  hydrochloric  acid 
will  effectually  remove  it,  and  render  unnecessary  the  perform- 
ance of  an  operation.  Common  sense  will  convince  the  reader 
that  the  cause,  namely,  the  severe  curb,  must  not  be  again 
applied. 

In  the  third  form  of  injury,  namely,  the  hyperostosis,  all  the 
the  treatment  necessary  is  the  removal  of  the  cause,  and  the 
application  of  soothing  remedies,  succeeded  by  frictions,  with 
iodine  ointment. 

3d.  Fractures  of  the  inferior  maxilla  occur  at  the  boundaries 
of  the  alveolae  of  the  incisor  teeth  by  the  forcible  "  punching 
out"  of  the  temporary  incisors — more  especially  the  corner 
bones.  This  cruel  procedure  is  resorted  to  for  the  purpose  of 
making  the  animal  appear  older  than  he  really  is.  It  cannot 
be  too  highly  censured,  and  no  veterinary  surgeon  should 
ever  be  guilty  of  doing  such  a  thing.  It  can  in  no  way  benefit 
the  horse,  and  the  idea  that  the  removal  of  the  temporary  teeth 
hastens  the  development  of  the  permanent  ones,  is  founded  on 
the  grossest  ignorance.  Doubtless,  the  permanent  teeth  are 
sooner  brought  into  view.  This,  however,  does  not  arise  from 
any  increase  of  their  growth,  but  from  the  removal  of  the  mem- 
brane by  which  they  are  covered.  Still,  when  the  bones  are 
fractured,  the  veterinary  surgeon  must  give  relief  as  speedily 
as  possible.  All  loose  fragments  of  bone  must  be  removed,  and 
the  wounds  washed  out.  Occasionally,  the  gum  and  membrane 
of  the  mouth  will  be  found  torn  to  a  considerable  extent — the 
ends  hanging  loosely  in  the  mouth.'  These  must  be  brought 
together,  and  secured  by  suture.  After  this  is  done,  all  that 
is  necessary  is  to  cleanse  the  mouth  occasionally  with  a  weak 
solution  of  chloride  of  lime  or  carbolic  acid,  and  to  place  the 
animal  on  soft  diet. 

4th.  Fracture  of  the  rami  of  the  lower  jaw  may  occur  from  other 
causes  than  that  of  the  horse  falling  upon  his  mouth — such  as 
kicks  from  other  horses,  or  any  other  external  violence.  The 
fracture  may  be  in  front  of,  posterior  to,  or  in  a  line  with  the 
tush.     If  the  tush  is  loosened,  it  must  be  removed;   but  this 


94'  PAETICULAR  FRACTURES. 

is  not  to  "be  done  unless  it  is  loose,  as  it  may  be  of  great  service 
in  securing  the  bone  in  its  position,  as  already  shown.  The 
presence  of  such  a  fracture,  if  simple,  will  be  indicated  by 
tenderness,  and  perhaps  crepitation ;  if  compound,  its  condition 
is  detected  by  exploration  of  the  wound.  If  the  fracture  extends 
through  the  jaw,  with  displacement,  there  will  be  deformity,  in 
addition  to  the  other  symptoms. 

I  have  never  seen  a  simple  fracture  of  this  part,  but  such  a 
thing  may  occur ;  the  most  common  form,  however,  is  that  of 
a  compound  comminuted  fracture  of  the  external  surface  only ; 
the  alveolus  and  contained  tooth,  by  breaking  the  concussive 
shock,  prevent  the  fracture  from  extending  to  the  internal 
surface.  Presuming,  how^ever,  that  the  fracture  is  complete, 
it  may  be  single  or  double,  with  displacement.  If  simple, 
replacement,  adjustment,  and  retention  of  the  disunited  parts, 
in  their  proper  position  are  the  means  to  be  resorted  to;  if 
compound  and  comminuted,  the  removal  of  all  loose  fragments 
must  be  the  first  proceeding.  In  order  to  do  this  effectually, 
it  will  often  be  necessary  to  enlarge  the  wound,  and,  provided 
there  is  no  previous  disease  of  the  bone,  a  cure  may  confidently 
be  looked  for. 

When  the  broken  ends  are  brought  together,  means  calculated 
to  retain  them  in  their  proper  position  must  be  resorted  to. 
If  the  injury  is  near  the  symphysis,  the  copper  wire  and  band- 
ages already  recommended  will  be  sufficient ;  but  if  situated 
posterior  to  the  tush,  something  more  than  this  is  required. 
Professor  Varnell,  in  the  Veterinarian  for  1866,  recommends 
a  cradle  made  as  follows  : — "  The  cradle  will  be  from  fifteen  to 
eighteen  inches  long ;  it  should  extend  as  far  back  as  the  angle 
of  the  lower  jaw,  and  as  far  forward  as  to  be  within  an  inch  of 
the  anterior  margin  of  the  lower  lip.  Its  sides  should  turn  up, 
so  as  to  embrace  the  outer  surfaces  of  each  branch  of  the  bone, 
and  be  on  a  line  with  the  upper  margin  of  the  under  lip,  beyond 
which  they  should  rise  to  within  a  short  distance  of  the  zygo- 
matic ridges.  Posteriorly,  it  should  incline  upw^ards  and  back- 
wards ;  the  centre  of  its  underneath  surface  should  be  pushed 
upwards,  forming  thereby  a  ridge,  which  is  to  fill  up  the  space 
between  the  rami  as  far  forward  as  the  symphysis  of  the  jaw- 
bone. Its  angles  must  be  rounded  off,  and  its  borders  perfor- 
ated by  holes  or  slits,  so  as  to  enable  the  operator  to  apply 


FACE  CRADLE,  DEisK.NED  i;Y  Mil  WALKEK'    VS.  DuADForj 


i^h-.  1. 


^ 


1.  Padding  to  protect  the  poll. 

2.  Brow  band. 

3.  Throat  lash. 

4.  Pad  for  submaxillary  space — to  be  made  of   wood,    and    well   padded 

with  leather. 
5-5.  Flanges  to  rest  on  first  molars. 
6.   Supplementary  strap  slits. 
7-7-7-7.  Straps — which  all  pass  vmder  the  lower  jaw. 

8-8.  Thumb-screws  for  lengthening  or  shortening  the  plate,  designed  by  Mr. 
Broad,  Bath. 


> 


•  —1 


\^ 


^ 

c8 

c 

^ 

r^ 

^ 

-3 

o 

^ 

-u 

-t^ 

2 

§ 

0) 

4^ 

;■» 

a. 

K 

■ 

fl 

o 

c; 

so 

a 

<S 

o 

;h 

^ 

O 

E^ 

^ 

A 

73 

-va 

-3 
o 

'% 

^ 

■^ 

^ 

S3 

^ 

® 

2 

If! 

c 

^ 

'» 

s" 

i 

cS 

o 

-• j 

^ 

2 

Q 

l* 

2 

0! 

.£ 

y3 

^ 

-4^ 

^ 

.J^ 

•1/ 

••—J 

^j 

^ 

^ 

;H 

5- 

c3 

-■ 

i-H 

&fi 

'^ 

O 

o 

T! 

-^3 

05 

■M 

1 

Q) 

s; 

J5 

"^ 

"^ 

o 

t: 

e3 

t/) 

h 

i 

^ 

2 

:n 

fl 

^ 

O  r-- 


o 

o 

03 

c/ 

« 

t— 5 

M 

■•-» 

2 

5C' 

Ed 

1> 

■ts 

C3 

--' 

h 

"o 

tS 

£ 

?► 

jm. 

'•'. 

-u 

^ 

FACE  CRADLE,  designed  by  Me.  WALKEK.  V.S,  Bkadfoiui 

Fio.  Ill 


Figure  III.  shows  the  apparatus  fixed  on  the  head  For  a  smaller  head  it  Is 
necessary  to  shorten  the  apparatus  by  turning  the  thumb-screws,  as,  if  it  extended 
beyond  the  muzzle,  the  patient  would  be  unable  to  feed. 


FRACTURES  OF  THE  FACIAL  BONES.  95 

straps,  &c.,  to  secure  it  in  its  place.  If  straps  are  used,  they 
may  be  placed  as  follows : — One  may  pass  from  a  little  below 
the  siipero-posterior  angles  round  the  back  part  of  the  horse's 
head,  behind  the  ears ;  a  second,  from  the  upper  borders  of  the 
cradle,  a  little  in  front  of  the  supero-posterior  angles.  This 
should  pass  across  the  brow,  in  front  of  the  ears.  A  third,  a 
small  strap,  may  pass  from  one  of  the  two  straps  to  the  other, 
between  the  ears.  A  fourth  may  proceed  from  the  middle  of 
the  upper  borders  of  the  cradle,  across  the  front  of  the  face,  a 
little  below  the  orbits ;  and  a  fifth  may  pass  across  the  nasal 
bones,  sufficiently  above  the  nostrils,  not  to  interfere  with  the 
horse's  breathing.  The  two  last-named  straps  should  be  partly 
elastic,  the  last  one  more  so  than  the  other,  so  as  to  allow  the 
horse  to  open  his  mouth  to  a  slight  extent. 

"  Should  the  fracture  be  compound,  some  holes  will  be  required 
in  the  cradle  opposite  to  the  seat  of  the  injury.  Perforations 
of  this  kind  can  be  made  after  the  cradle  is  manufactured. 

"  As  horses'  heads  vary  both  in  size  and  form,  it  is  not  to  be 
expected,  even  though  a  practitioner  has  two  or  three  of  these 
cradles  on  hand,  that  any  one  of  them  will  fit  the  parts  with 
that  exactness  he  could  wish.  The  inequalities,  therefore,  must, 
as  before  stated,  be  filled  with  a  padding  of  tow,  or  some  other 
agent,  in  addition  to  that  which  should,  on  all  occasions,  be 
used  as  a  lining  to  the  inner  surface  of  a  cradle  or  splint. 

"  He  who  is  called  upon  to  treat  a  case  of  fracture  of  the  lower 
jaw  of  a  horse  must  not  despair  if  he  does  not  possess  any  other 
splints  than  those  he  is  obliged  to  make  at  the  time.  The 
principal  object,  after  the  ends  of  the  broken  bone  are  brought 
in  apposition,  is  to  retain  them  there  until  they  are  united ;  and 
the  practitioner  should  endeavour  to  accomplish  this  with  as 
little  inconvenience  to  the  horse  as  possible." 

The  method  recommended  by  Professor  Yarnell  seems  com- 
plicated, but  coming  from  such  a  source,  it  deserves  every 
respect.  Mr.  Walker,  V.S.,  Bradford,  has  designed  a  cradle, 
which  has  answered  the  purpose  very  wxll  in  at  least  two 
cases,  where  the  fractures  were  posterior  to  the  tushes,  and  in- 
volving both  rami.  He  has  kindly  sent  the  following  drawings 
of  it. — {See  Engravings.) 

The  tendency  of  the  fractured  ends  to  fall  inwards  is  the 
only  real  obstaclo  we  have  to  contend  with ;  so  if  we  can  by 


96  PARTICULAR  FRACTURES. 

any  inethod  fill  up  the  submaxillary  space,  we  shall  overcome 
this  difficulty.  The  pad  (a)  in  Mr.  Walker's  cradle  answers  this 
purpose ;  and  the  flanged  plates  {b)  resting  on  the  molar  teeth 
render  displacement  of  the  fragments  almost  an  impossibility, 
whilst  every  freedom  is  allowed  to  the  natural  movements  of 
the  jaw. 

It  must  be  borne  in  mind  that  the  adjustment  of  the  fractured 
parts  nnist  be  made  with  great  care,  in  order  that  the  molar 
teeth  may  meet  those  in  the  upper  jaw  as  evenly  as  possible ;  • 
otherwise  the  process  of  mastication  will  afterwards  be  imper- 
fect. If  any  teeth  are  loosened  in  their  sockets,  they  must  be 
removed,  as  they,  by  acting  as  foreign  bodies,  and  preventing 
the  proper  adjustment  of  tlie  fractured  ends  of  the  bone,  retard 
the  process  of  union.  In  addition  to  these  means,  the  unin- 
jured teeth  may  be  fastened  togetlier  by  the  copper  wire.  If 
the  injury  has  been  in  existence  for  a  day  or  two,  with  swell- 
ing, and  perhaps  systemic  disturbance,  it  will  be  necessary  to 
remove  these  symptoms,  as  well  as  to  adjust  the  brolven  bone. 
Apply  fomentations  to  the  part,  and  give  a  dose  of  purgative 
medicine.  Motion  of  the  jaw  must,  for  some  days,  be  prevented 
as  much  as  possible,  supporting  the  animal  during  this  time  by 
a  loose,  nourishing  diet,  such  us  bran-mashes,  boiled  linseed,  and 
gruel.  If  the  formation  of  callus  seems  retarded  from  any  cause, 
milk  may  be  allowed — of  which  the  horse  will  drink  freely — and 
thick  oatmeal  porridge.  In  fact  the  strength  of  the  animal  must 
be  kept  up  without  causing  the  jaw  to  perform  any  hard  labour. 
The  practitioner  will  at  once  see  the  importance  of  this.  There 
is  one  other  thing  in  connection  with  the  treatment  of  all  kinds 
of  fractures  of  the  bones  of  the  mouth  that  I  must  insist  upon 
as  being  most  important,  namely,  that  all  food  be  given  in  a 
wide-bottomed  and  shallow^  manger  or  tub.  If  the  manger  is 
narrow  and  deep,  displacement  of  the  bones,  from  the  efforts  of 
the  patient  to  get  at  the  food,  is  sure  to  result. 

All  j)ieces  tliat  are  separated  from  the  body  of  the  bone,  as 
well  as  those  denuded  of  periosteum — even  if  attached  by  one 
end — partly  split  off,  as  it  were — must  be  removed,  either 
with  the  common  or  bone  forceps  ;  and  the  wound  must  then 
be  covered  by  fine  tow  dipped  in  a  weak  solution  of  carbolic 
acid ;  a  hole,  as  already  described,  being  left  in  the  mould  for 
the  purpose  of  renewing  this  dressing,    and  for  cleansing  the 


FRACTURES  OF  THE  FACIAL  BONES.  97 

Avound,  if  necessary.  It  is  found,  since  the  introduction  of 
antiseptic  surgery,  that  the  wound  often  remains  dry,  and  that 
it  heals  by  the  adhesive  inflammation.  If  such  be  the  case, 
the  dressing  must  on  no  account  be  interfered  with,  and  means 
must  be  taken  to  keep  it  in  its  place,  either  by  the  applica- 
tion of  collodion,  styptic-colloid,  or  gutta-percha  paste.  When 
a  loose  portion  of  bone  remains,  its  presence  may  be  detected 
by  the  continued  foetor  of  the  discharge,  and  by  an  ulcer  in  the 
skin  communicating  by  means  of  a  sinus  with  the  bone 
within.  In  all  cases  where  a  loose  piece  of  bone  is  found  in 
the  part  some  time  after  the  accident,  it  will  be  advisable,  if  its 
removal  is  not  easily  accomplished,  to  allow  some  weeks  to 
elapse  before  forcibly  extracting  it,  in  order  that  the  union  and 
consolidation  of  the  fracture  may  be  complete.  The  opening  in 
the  skin  may  then  be  enlarged,  and  the  necrosed  bone  removed 
by  the  forceps  or  tenaculum. 

ISTo  alarm  need  be  felt  at  the  foetor  of  the  discharge  during  the 
first  few  days  after  the  accident,  for  as  a  rule  this  is  always  pre- 
sent. The  discharge  is  at  first  thin,  dark-coloured,  and  foetid ; 
but  if  not  too  profuse,  it  does  not  indicate  any  serious  results,  for 
it  very  shortly  becomes  lighter  in  colour,  less  offensive  in  odour, 
and  partakes  more  of  the  nature  of  laudable  pus.  Every  facility 
must  be  given  for  the  discharge  to  drain  away,  and  the  wound 
may  be  injected  with  a  weak  solution  of  hydrochloric  acid.  I 
recommend  this  in  preference  to  all  other  dressings  in  such 
cases,  as  it  dissolves  the  earthy  matters  of  the  necrosed  sur- 
faces of  the  bones,  and  thus  facilitates  the  formation  of  a  healthy 
healing  surface.  I  have  used  it  for  years,  and  can  speak  most 
highly  of  it.  Much  pain  is  manifested  by  the  animal  in  some 
cases  of  this  kind  of  fracture,  from  the  inferior  dental  division 
of  the  posterior  maxillary  branch  of  the  fifth  nerve  being  in- 
volved in  the  injury.  In  such,  much  relief  will  be  given  by 
dressing  the  wound  with  a  solution  of  morphia,  or  by  the  ad- 
minstration  of  opium :  the  local  application  is  the  better  practice, 
and  as  little  medicine  as  possible  should  l)e  given  after  the 
first  dose  of  physic,  for  fear  of  causing  displacement.  If  the 
bowels  are  constipated,  enemas  ought  to  be  administered,  and 
the  food  should  be  of  a  laxative  nature — linseed,  bran,  boiled 
turnips,  or  carrots ;  or  what  Mr.  Anderson,  V.S.,  Glasgow, 
recommends — linseed  oil  in  a  warm  bran-mash.     The  patient, 

H 


98  PARTICULAR  FRACTURES. 

as  a  rule,  will  eat  it.  Gentle  exercise  is  to  be  given  from  da}'' 
to  day ;  and  in  order  to  prevent  the  patient  eating  the  bedding, 
it  should  have  a  loose  box  littered  with  sawdust.  In  about  a 
fortnight  after  the  accident,  if  the  case  does  well,  chopped  hay 
may  be  allowed,  with  boiled  oats  and  bran.  I  have  heard  of  a 
case  of  fracture  of  the  condyle  of  the  lower  jaw,  with  open  joint, 
and  that  the  patient  recovered,  with  perfect  motion  in  the 
articulation.  Such  a  thing  may  be  possible,  but  is  scarcely 
credible. 

Fracture  of  Anterior  Maxillary  Bone  must  be  treated  in 
the  way  already  laid  down — that  is,  by  the  copper  wire  and 
bandage. 

Fracture  of  the  Nasal  Bones  occurs  rather  frequently,  from 
runaw^ay  horses  coming  in  contact  with  hard  substances,  such  as 
lamp-posts,  &:c.  As  a  rule,  one  of  the  bones  is  fractured,  but 
occasionally  both  are  found  broken.  In  old  horses  these  bones 
are  much  more  easily  fractured  than  in  young  ones,  for  the  simple 
reason  that  their  great  elasticity  in  the  young  enables  them  to 
bear  and  resist  violent  shocks  of  concussion.  These  fractures 
may  be  complete,  or  partial  only, — in  the  latter  case  the  outer 
plate  of  the  bone  being  broken,  and  the  inner  bent  in  without 
being  fractured.  When  it  is  complete,  it  will  be  found  that 
the  Schneiderian  membrane  is  lacerated,  with  perhaps  sharp 
fragments  of  the  bone  sticking  through  it.  This  will  be  more 
particularly  the  case  in  the  lower  portion  of  the  nose.  If  the 
lesion  is  at  the  upper  part,  the  fragments  will  be  driven  into 
the  facial  sinuses.  The  symptoms  of  fracture  of  these  bones 
will  be  depression ;  haemorrhage  from  the  nose ;  and  if  the 
depression  is  extensive,  the  breathing  will  be  impaired  by  the 
inward  bulging  of  the  displaced  bones.  I  remember  a  case 
where  this  impairment  was  a  permanent  unsoundness.  The 
fracture  was  an  old  one,  when  seen  by  me,  with  considerable 
depression  upon  the  front  of  one  nostril.  When  the  horse  was 
quiet  there  was  no  noise  in  the  breathing,  but  when  put  to 
work,  there  was  a  sound  emitted  during  both  acts  of  respira- 
tion, accompanied  occasionally  by  haemorrhage.  The  case  was 
tried  at  the  Halifax  County  Court;  Mr.  Dray,  of  Leeds,  and 
myself  certifying  to  the  unsoundness  of  the  horse;  the  Judge, 
^fr.  Stansfield,  concurring,  and  giving  judgment  accordingly. 

In  the  treatment  of  this  fracture,  whether  it  be  simple  or 


FRACTURES  OF  THE  FACIAL  BOXES.  99 

otherwise,  an  endeavour  must  be  made  to  readjust  the  bones  in 
their  proper  position.  Professor  Varnell  recommends  that  "  a 
piece  of  wood  should  be  prepared,  about  one  and  a  half  inches 
wide,  about  half  an  inch  thick,  and  of  sufficient  length  for  the 
purpose.  This  piece  of  wood  should  have  its  angles  rounded 
off,  and  that  part  of  it  which  is  required  to  be  passed  up  the 
nasal  passage  should  be  covered  with  a  piece  of  thin  wash-leather, 
to  prevent  the  possibility  of  any  splinter  injuring  the  mucous 
membrane.  The  operator  being  thus  provided,  and  the  horse 
favourably  placed  and  secured,  this  rude  instrument  is  to  be 
passed  up  the  nostril  of  the  side  affected,  as  far  as  a  little 
beyond  the  seat  of  the  fracture,  when  as  much  force  as  may  be 
necessary,  or  deemed  prudent,  should  be  used  to  raise  the  de- 
pressed fragments  of  bone.  If  the  fracture  is  compound, 
and  any  portion  of  the  bone  projects  through  the  skin  (which 
is  not  very  likely  to  be  the  case),  it  must  be  dealt  with  as 
recommended  in  compound  fracture  of  the  lower  jaw;  or  if  it  is 
comminuted,  and  a  fragment  is  found  to  be  wholly  detached,  it 
should  be  removed  with  the  forceps. 

"  The  segments  of  the  fractured  bone  having  been  adjusted 
as  nearly  as  possible  in  their  proper  position,  means  should  be 
devised  to  retain  them  there.  For  this  purpose  two  modes 
suggest  themselves.  The  first  is  as  follows: — To  clear  the  skin 
as  much  as  possible  from  dirt  and  other  extraneous  matter, 
and  when  it  is  thoroughly  dry,  to  place  some  straps  of  strcm^g 
adhesive  plaster  across  the  fractured  bones.  These  should  be 
carried  a  little  beyond  their  outer  boundaries,  and  in  such  direc- 
tion as  may  be  thought  best. 

"  These  straps,  if  well  applied,  will  be  found  to  answer  a  very 
good  purpose,  especially  when  the  bone  is  much  splintered  or 
the  skin  penetrated,  as  in  compound  fracture.  In  the  latter 
they  will  close  the  opening,  and  thus  to  some  extent  reduce 
it  to  a  simple  one ;  they  wiU  also  materially  support  the  broken 
bone,  and  thus  prevent  any  portion  of  it  from  falling  into  the 
nasal  passage  or  the  nasal  sinus. 

"  The  other  mode  of  keeping  the  fractured  bone  in  its  proper 
position,  which  may  be  used  with  or  without  the  former,  and 
which  also  tends  to  arrest  haemorrhage,  should  it  exist  to  any 
extent,  is  to  plug  the  nasal  passage  with  fine  tow  or  cotton  wool. 
This  may  be  done  in  the  following  way  with  perfect  safety : — 


too  PARTICULAR  FRACTURES. 

"  A  piece  of  soft  but  strong  twine  may  be  firmly  tied  around 
a  small  bundle  of  the  above  agents,  which  should  be  sufficiently 
large  to  fill  the  passage.  The  free  end  of  the  string  should  be 
lono^  enouLih  to  reach  some  little  distance  out  of  the  nostril, 
whereby  the  operator  may  be  enabled  to  hold  it  firmly  while 
the  rest  of  the  passage  is  being  plugged. 

"  By  this  arrangement  the  wdiole  of  the  plugging  can  be  re- 
moved at  any  time  that  may  be  deemed  advisable,  and  there 
w^ill  be  no  danger  of  any  portion  of  it  passing  in  a  backward 
direction  through  the  posterior  nares  into  the  fauces. 

"  There  need  be  no  apprehension  about  the  horse's  breath- 
ing being  interfered  with,  if  one  of  the  nasal  passages  only 
is  plugged ;  but  I  need  not  say  that  both  should  not  be  so 
treated,  as  the  horse  cannot  breathe  through  his  mouth." — 
(Professor  Varnell,  in  Veterinarian,  l:^OYembev  1866,  pp.  875-6.) 

If  this  method  should  be  found  impracticable,  and  more 
especially  if  the  fracture  is  a  compound  one,  the  broken  bones 
should  be  raised  from  the  outer  surface  by  means  of  a  strong 
tenaculum  or  hook,  which  is  easily  introduced  into  the  edge 
of  the  fracture;  the  parts  must  afterwards  be  strapped,  as 
recommended  above,  and  in  all  cases  the  patient  must  have  rest. 

Should  the  discharge  from  the  nose,  which  is  always  sure  to 
succeed  the  haemorrhage  in  this  kind  of  fracture,  continue,  and 
become  more  profuse,  foetid,  curdled,  or  sanious,  a  search  must 
be  made  for  any  detached  piece  of  bone  which  may  exist  in  the 
part ;  w^hen  found,  it  must  be  removed,  and  the  portions  of 
healthy  bone  in  contact  with  it  dressed  with  the  dilute  hydro- 
chloric acid,  as  the  mere  contact  with  necrosed  bone  is  apt  to 
cause  a  necrosed  or  carious  condition  of  the  edges  in  such 
contact. 

Horses  have  been  condemned  for  glanders  while  only  suffer- 
ing from  the  presence  of  loose  pieces  of  fractured  bone  in  the 
nasal  region,  and  it  is  maintained  by  some,  that  fracture  of  the 
nasal  bones  is  of  itself  sufficient  to  produce  glanders;  but  I 
cannot  conceive  how  a  disease  due  to  a  specific  virus  can  arise 
from  a  mere  accident,  although  the  discharge,  ulceration,  &c. 
may  closely  resemble  the  specific  disease.  To  remove  foetor, 
and  to  promote  a  healthy  condition  of  the  mucous  membrane, 
the  nostrils  may  be  daily  syringed  with  very  dilute  carbolic 
acid,  solution  of  chloride  of  lime,  or  Condy's  fluid. 


FllACTURES  OF  THE  FACIAL  BONES.  101 

Fractures  of  the  Superior  Maxillary  Bone  are  generally 
caused  by  blows  upon  the  face  with  the  butt- end  of  the  whip, 
given  by  a  bad-tempered  and  savage  horseman.  As  a  rule, 
these  fractures  are  situated  anterior  to  the  maxillary  spine,  and 
immediately  over  the  superior  maxillary  sinus,  into  which  the 
fragments  fall.  The  fracture  is  usually  compound  and  com- 
minuted, and  is  easily  diagnosed  by  the  egress  of  the  air 
expelled  by  the  patient  during  each  time  of  expiration. 

Treatment. — Eemove  all  loose  portions,  bring  the  edges 
of  the  wound  together  by  suture,  and  apply  the  collodion 
dressing. 

The  Frontal  Bones  are  broken  by  falls  and  other  severe 
accidents;  the  seat  of  the  fracture  is  usually  found  in  the 
orbital  process.  The  anatomist  knows  that  the  frontal  bones 
enter  into  the  formation  of  both  cranium  and  face.  If  the 
facial  portion  be  fractured,  there  is  but  little  danger  of  imme- 
diately fatal  results  ;  but  if  the  cranial  portion  is  thus  injured, 
death  may  be  instantaneous,  particularly  if  tlie  blow  has  been 
sufficient  to  fracture  both  plates  of  the  bone.  Occasionally,  but 
very  rarely,  the  orbit  is  pierced  by  a  sharp-pointed  instrument, 
and  the  orbital  plate,  which  is  thinner  than  any  other  portion 
of  the  cranial  bones,  is  penetrated,  and  the  brain  seriously 
injured.  In  the  most  usual  form,  namely,  fracture  of  the  orbital 
process,  it  is  obvious  that  many  important  organs  contained 
within  the  cavity  of  the  orbit  may  be  seriously  hurt,  such  as 
the  supero-orbital  division  of  the  fifth  nerve,  its  accompanying 
artery,  lachrymal  glands,  and  even  the  eye  itself.  Sometimes  a 
small  piece  of  the  anterior  border  is,  as  it  were,  chipped  off, 
and  the  tarsal  ligament  detached  from  it,  which  makes  the  case 
difficult  to  manage. 

Professor  Yarnell  says  that  "  there  is  a  great  tendency  in 
this  part  of  the  bone,  when  injured,  to  ulcerate  and  crumble 
away."  I  have  not  observed  this ;  but  it  may  be  due  to  the 
circumstance  that  I  make  it  a  point  in  practice  never  to  allow 
detached  fragments  of  bone  to  remain  in  the  wound.  When 
the  orbital  process  is  completely  fractured — say  a  simple  frac- 
ture from  a  severe  blow  with  a  blunt  instrument — the  fractured 
ends  are  driven  inwards  by  the  force  of  the  concussion.  In 
such  a  case,  the  eye  will  be  completely  closed  ;  and  if  there  be 
no  swelling  or  bruise,  the  closure  of  the  eye  is  the  only  symp- 


102  PARTICULAR  FRACTURES. 

torn  of  the  injury :  there  is  both  paralysis  and  mechanical  dis- 
placement of  the  eyelid. 

The  treatment  of  such  a  case  is  to  elevate  the  depressed  ends 
of  the  bone  ;  and  to  do  this  it  may  be  necessary  to  introduce 
a  small  lever  under  the  skin,  making  the  incision  through 
which  it  is  to  be  passed  close  to  the  zygomatic  ridge,  and 
pushing  the  instrument  subcutaneously  until  the  seat  of  the 
fracture  is  reached,  when  the  elevation  may  be  effected;  if 
the  lever  is  put  under  the  centre  of  the  depression,  both  ends 
may  be  elevated  simultaneously.  Considerable  force  is  neces- 
sary, but  it  must  be  applied  carefully  and  steadily.  Let  there 
be  no  jerking,  but  steady,  continued  pressure.  I  have  seen  the 
eye  recover  almost  its  natural  shape  when  this  has  been  done. 
Little  else  is  required  locally  ;  the  animal  is  to  be  kept  at  rest, 
the  wound  made  by  the  operator  covered  over  with  collodion, 
and  low  diet  prescribed ;  a  dose  of  physic  may  be  given,  and  the 
animal  carefully  watched  for  a  few  days  by  the  veterinary 
surgeon,  who  will  adopt  such  treatment  as  may  be  suggested  by 
the  symptoms.  If  the  fifth  nerve  be  damaged,  there  is  found 
to  be  a  tendency  to  tetanus ;  all  causes  of  excitement  must 
therefore  be  guarded  against. 

Should  the  fracture  be  compound  or  comminuted,  the  treat- 
ment already  laid  down  must  be  employed. 

The  outer  plate  may  be  fractured  over  the  centre  of  the 
frontal  sinus ;  it  may  be  merely  bent  inwards,  from  partial 
fracture ;  or  it  may  be  completely  shattered,  and  the  skin 
penetrated. 

If  there  be  mere  depression,  there  should  be  no  interference, 
as  the  indented  bone  will  not  press  upon  any  organ,  and  the 
only  results  will  be  a  slight  blemish  externally,  and  diminution 
of  the  sinus  within.  A  dose  of  physic  should  be  given — febri- 
fuges if  necessary — and  a  short  period  of  rest  allowed. 

But  if  the  injury  has  penetrated  the  skin,  and  broken  the 
bone  into  fragments,  it  becomes  the  duty  of  the  veterinarian  to 
remove  all  such  fragments,  whether  they  are  attached  to  the 
fractured  borders,  or  have  been  forced  into  the  cavity ;  to 
thoroughly  cleanse  the  sinus  from  all  clots  of  blood  and  other 
foreign  bodies  ;  for  if  these  remain,  their  decomposition  will  be 
productive  of  much  mischief.  When  these  things  are  done, 
the  forehead  is  to  be  strapped  with  pitch-plaster,  and  the  con- 
stitutional treatment  above  described  adopted. 


FRACTURES  OF  THE  FACIAL  BONES.  103 

The  haemorrhage  may  continue  for  some  hours  after  such  an 
accident,  and,  of  course — from  the  sinus  being  continuous  with 
the  nasal  cavity — the  blood  will  flow  through  the  nostril.  This 
need  occasion  no  alarm ;  the  pouring  of  cold  water,  both  into 
the  sinus  and  on  the  face,  will  generally  arrest  it ;  or  two 
ounces  of  the  tincture  of  terchloride  of  iron  may  be  mixed  with 
a  bucketful  of  water,  and  syringed  into  the  wound  by  means 
of  an  elastic  enema  syringe. 

I  do  not  recommend  the  application  of  poultices  to  injuries 
of  this  kind,  nor  disturbance  of  the  parts  after  the  first  dressing, 
which  must  be  effective  and  complete ;  but  should  the  swelling 
become  excessive,  or  a  purulent  discharge  manifest  itself,  it 
becomes  a  duty  to  apply  fomentations  of  warm  water  in  which 
a  little  carbolic  acid  has  been  dissolved,  and  the  general  treat- 
ment of  wounds  which  will  be  hereafter  laid  down  must  be 
resorted  to.  If  at  any  time  the  wound  assume  an  unhealthy 
character,  with  a  thin  foetid  discharge,  caries  of  the  bone  is 
indicated,  and  this  will  require  the  hydrochloric  acid  dressing, 
care  being  taken  that  the  diseased  bone  receives  the  application. 
It  must  never  be  forgotten  by  the  practitioner  that  an  injury  to 
any  part  of  the  cranium  may  be  much  more  serious  than  may 
at  first  appear.  The  effects  of  the  shock,  although  this  is  pro- 
vided for  by  the  double  layer  of  bony  plates,  may  scarcely  be 
apparent;  but  unexpected  symptoms  may  arise,  indicative  of 
severe  lesions  to  the  brain  and  nervous  system. 

Fracture  of  the  immediate  walls  of  the  cranium  may  be  pre- 
sent, involving  the  vessels  of  the  brain,  and  when  such  is  the 
case,  the  termination  is  generally  fatal. 

I  have  seen  the  zygomatic  ridge  broken  on  its  outer  edge, 
the  fragments  remaining  in  the  wound,  and  requiring  re- 
moval. 

I  have  little  to  add  upon  fracture  of  the  facial  bones.  Any 
of  them,  where  they  are  exposed  to  external  influences,  may  be 
fractured;  and  should  such  fractures  involve  organs  or  vessels 
of  importance,  the  case  becomes  the  more  complicated.  For 
example,  the  lachrymal  duct  may  be  involved  in  fracture  of  the 
bone  of  the  same  name ;  the  fractured  bone  may  heal,  but  the 
duct  will  be  spoiled ;  and  the  lachrymal  secretion,  instead  of 
being  discharged  into  the  nostril,  will  flow  over  the  face. 
Again,  the  parotid  duct  may  be  opened  in  a  fracture  of  the 


104 


PARTICULAR  FRACTURES. 


lower  jaw,  or  the  inferior  maxillary  division  of  the  fifth  nerve 
may  be  injured  and  pressed  open  by  a  piece  of  depressed  bone, 
causing  excruciating  pain,  and  even  fatal  results,  if  not  at  once 
removed. 


FRACTURES  OF  THE  CRANIAL  BONES. 

By  the  arrangement  of  the  cranial  bones,  an  ovate  box  is 
formed,  which  resists  external  violence  after  the  manner  of  an 
arch ;  yet  it  is  sometimes  fractured  by  the  direct  application 

of  force  to  the  fractured  parts,  but 
more  frequently — in  the  lower  ani- 
mals, especially  in  the  horse — at  a 
part  of  the  skull  distant  from  the 
place  where  the  violence  has  been 
received.  This  is  called  "indirect 
frachtre"  or  fracture  hy  counter- 
stroke,  or  what  is  termed  by  the 
French,  fracture  par  contre-coup. 

Fractures  of  the  base  of  the  skull 
are,  in  all  instances,  caused  by  the 
indirect  application  of  violence,  and 
this  is  easily  explained.  If  a  horse 
fall,  or  be  struck  heavily  by  a  blunt 
instrument  or  obtuse  body,  upon  the 
occipital  crest,  the  force  thus  applied 
is  resisted  by  the  strength  and  thick- 
ness of  this  part  of  the  bone,  and  the 
shock  is  conveyed  to  the  basilar 
process,  this  being  its  weakest  part. 
In  all  cases  this  form  of  fracture 
Fig.  11  —Indirect  comminuted  fg  necessarily  fatal. 

fracture  of  basilar  process  of  occi-  _,  .  ,  .    , 

pitai  and  sphenoidal  bones,  from       Sometimes    the    Violence   ot    the 
falling  on  occipital  crest,   a,  Occi-  faU  or  blow  is  Sufficient  to  producc 

pitaL     b,  Sphenoid.  ^  •   -,     ■ 

fracture  of  the  part  to  which  it  is 
applied,  and  also  to  extend  to  the  base  of  the  cranium. 

The  fractures  of  the  cranium  may  be  conveniently  arranged 
as  follows  : — 

\st.  Simple  fissure  or  fracture  without  depression. 

2d.  Simple  fractures  with  depression. 


FRACTURES  OF  THE  CRANIAL  BONES.  105 

Sd.   Punctured  fractures. 

4th.  Compound  fractures. 

6th.  Fracture  of  external  table  only. 

6th.  Fracture  of  the  internal  table  only. 

1.  Simple  Fissure. — In  this  form  there  is  no  wound  of  the  soft 
parts,  and  the  broken  pieces  preserve  their  proper  level ;  and  if 
there  be  no  accompanying  injury  to  the  parts  within  the  cranium, 
it  is  not  necessary  to  do  more  than  guard  against  the  occurrence 
of  inflammation ;  but  the  force  which  breaks  the  bone  may  cause 
separation  of  the  dura  mater,  laceration  of  the  brain,  extravasa- 
tion of  blood  within  or  upon  it,  or  above  and  below  the  dura 
mater ;  or  a  mere  crack  in  the  outer  table,  with  fracture  and 
depression  of  the  inner  table.  There  may  be  immediate  con- 
cussion of  the  brain ;  or  inflammation  of  it  and  its  membranes, 
may  subsequently  appear  to  a  dangerous  or  even  fatal  extent. 

2.  Simple  Fracture,  loith  Depression. — In  this  form  there  will 
be  an  inequality  of  the  surface  of  the  skull,  varying  in  extent 
according  to  the  size  of  the  depression,  and  generally  associated 
with  a  bruise  of  the  skin.  Sometimes  the  fragments  are  un- 
yielding, and  sometimes  they  are  moveable.  A  condition  of  the 
skin  of  the  head  is  occasionally  seen,  which  is  apt  to  lead 
one  to  suppose  that  the  depression  is  much  greater  than  it 
is  in  reality,  or  to  think  that  the  bone  is  broken,  when  no 
fracture  exists.  This  is  a  swelling  caused  by  extravasation, 
and  it  occurs  in  this  manner: — A  blow  is  inflicted  by  a  flat 
instrument ;  this  blow  is  sufficient  to  deaden  and  paralyze  the 
vessels  of  the  part  itself,  which  remains  firmly  compressed; 
but  into  the  surrounding  areolar  tissue  blood  becomes  extra- 
vasated,  raising  the  soft  parts  to  a  considerable  extent.  This 
swelling  is  remarkably  firm,  and  this  condition  should  always  be 
kept  in  mind,  or  the  practitioner  may  think  there  is  a  fracture 
where  none  exists,  or  that  the  depression  of  fracture  is  much 
greater  than  it  is  in  reality. 

Fracture  with  depression  will  be  attended  by  other  symptoms 
than  the  local  ones  above  described,  namely,  by  compression  of 
the  brain;  and  when  a  depressed  piece  of  bone  occasions  the 
compression,  the  symptoms  present  themselves  on  the  occurrence 
of  the  injury ;  but  compression  may  arise  from  other  results  of 
an  injury  to  the  head  than  fracture.  For  example,  an  animal 
has  received  a  blow  on  the  head  which  may  stun  him ;  he  re- 


iOG  PARTICULAR  FRACTURES. 

covers  from  the  first  shock,  and  symptoms  of  compression 
afterwards  appear,  and  gradually  increase ;  there  are  then  just 
grounds  for  supposing  that  they  arise  from  extravasation  of 
blood  within  the  cranial  cavity. 

When  the  compression  arises  from  the  formation  of  pus,  the 
symptoms  do  not  present  themselves  for  several  days  after  the 
accident,  and  are  preceded  by  those  of  inflammation  of  the  brain 
or  its  meninges.  The  history  of  the  case  will  here  be  most  use- 
ful in  guiding  the  practitioner  to  arrive  at  a  proper  conclusion  as 
to  the  cause  of  the  compression. 

There  is  no  certain  correspondence  between  the  symptoms  of 
compression  and  the  extent  to  which  a  portion  of  bone  may  be 
depressed.  In  some  cases,  where  depression  has  been  slight,  the 
symptoms  have  been  very  marked ;  whilst  in  others,  the  symp- 
toms have  been  slight  and  the  depression  considerable.  It  is 
also  a  remarkable  fact  that  injury  to  one  table  of  the  bone 
scarcely  ever  corresponds  to  that  of  the  other ;  the  inner  being 
nearly  always  fractured  to  a  greater  extent  than  the  outer,  and 
its  actual  depression  much  greater  than  w^ould  appear  from 
examination  of  the  parts  external  to  the  fracture. 

The  treatment  must  be  pursued  in  accordance  with  the  symp- 
toms. In  the  absence  of  compression,  the  indication  is  to  prevent 
inflammation ;  and  for  that  purpose  purgatives  must  be  given, 
and  low  diet  with  rest  and  quietude  enjoined.  It  is  also 
necessary  to  keep  the  head  cool  by  means  of  cold  wet  cloths,  and 
after  the  period  of  collapse — which  immediately  succeeds  the 
injury — has  passed  off,  abstraction  of  blood  may  be  advisable. 
The  administration  of  sedative  medicines  had  better  be  withheld, 
as  they  may  produce  an  impression  upon  the  brain,  predisposing 
to  inflammatory  action. 

If  compression  be  present,  the  practitioner  must,  without 
delay,  attempt  to  relieve  the  brain  from  pressure.  If  the  bone 
be  not  depressed  to  any  great  extent,  and  the  symptoms  not 
urgent,  bleeding,  purging,  and  the  application  of  cold  to  the 
head  may  be  sufficient;  for  it  is  sometimes  found  that  the 
brain  becomes  accommodated  to  its  new  condition,  and  that  the 
symptoms  disappear;  but  if  these  means  should  not  succeed, 
the  depressed  bone  must  be  elevated.  When  the  symptoms  of 
compression  are  strongly  marked,  and  the  bone  depressed  to 
such  an  extent  as  to  leave  no  hope  from  other  treatment,  the 


FKACTUKES  OF  THE  CRANIAL  BONES.  107 

fracture  must  be  exposed  by  a  crucial  incision,  and  the  bone 
raised  by  an  elevator.  Sometimes  it  is  possible  to  introduce  the 
elevator  under  the  edge  of  the  fractured  bone  without  using  the 
trephine;  in  the  majority  of  cases,  however,  it  will  be  found 
necessary  to  remove  a  part  of  the  bone  that  is  not  depressed,  so 
as  to  admit  of  the  introduction  of  an  elevator,  by  which  the 
depressed  part  may  be  raised  to  a  level  with  the  surrounding 
parts  of  the  skull. 

The  best  form  of  trephine  is  the  one  with  a  moveable  centre- 
bit.  The  elevator  or  lever  is  a  very  simple  instrument,  and  can 
be  made  by  the  nearest  blacksmith,  being  merely  a  chisel  with  a 
slight  curve  or  elbow.  Should  the  fracture  of  the  inner  table  be 
comminuted,  all  loose  portions  must  be  carefully  picked  out 
with  the  forceps. 

Whilst  recommending  the  above  treatment,  I  am  bound  to 
admit  that  the  force  sufficient  to  cause  fracture  of  the  bones  of 
the  skulls  of  our  patients  is  generally  sufficient  of  itself  to  pro- 
duce instant  and  fatal  concussion  of  the  brain ;  but,  on  the  other 
hand,  it  will  be  found,  during  a  long  period  of  practice,  that 
cases  as  described  occur,  especially  in  a  city  like  Edinburgh, 
where  the  streets  are  hilly,  paved  with  granite,  and  the  horses 
shod  with  calkins  and  toe-pieces,  which  seem  to  take  from  the 
poor  animals  the  power  of  falling  naturally  when  they  make  a 
slip,  and  to  cause  them  to  tumble  head  foremost.  From  these 
causes,  fractures  of  all  kinds  are  of  frequent  occurrence. 

3.  Punctured  Fracture. — This  is  caused  by  a  sharp  body,  as  a 
pitchfork,  or  by  the  animal  falling  on  a  pointed  instrument  of 
any  kind ;  a  mere  puncture  or  cavity  being  the  outward  visible 
effect,  but  the  internal  table,  from  its  brittleness,  is  injured  to  a 
greater  extent  than  the  outer.  This  fracture  is  sometimes  called 
"star-like"  or  radiated  fracture,  from  the  fact  that  there  are 
numerous  fissures  or  cracks  in  the  bone,  radiating  from  the 
centre  of  the  fracture. 

This  is  a  very  dangerous  form  of  fracture,  requiring  immediate 
trephining,  although  symptoms  of  compression  may  be  absent. 
The  danger  arises  from  the  fact  that  spiculse  of  the  inner  table 
are  always  driven  inwards,  and  if  these  be  not  removed,  it  is  cer- 
tain that  inflammation  will  ensue.  If  the  operation  be  delayed 
till  then,  the  animal  will  most  assuredly  die. 

After  the  depressed  fragments  have  been  removed  (and  it  may 


108  PARTICULAR  FRACTURES. 

be  possible  to  do  this  without  trephining  or  removing  any  sound 
portion),  the  wound  must  be  closed,  and  the  most  strict  anti- 
phlogistic treatment  pursued,  both  to  prevent  inflammation  and 
to  subdue  it  in  case  of  its  occurrence. 

4.  Com'pcyiind  or  Open  Fracture  with  Depression,  is  the  most 
common  form  met  with  in  our  patients ;  a  force  strong  enough 
to  break  the  bones  being  sufficient  to  drive  in  the  soft  parts  also. 

There  is  a  wide  difference  of  opinion  amongst  surgical  writers 
as  to  the  necessity  of  immediately  elevating  the  depressed 
bone  in  this  form  of  fracture, — Sir  Astley  Cooper,  Sir  B.  Brodie, 
and  others  laying  it  down  as  a  law  that  trephining  must  be 
performed  as  soon  as  possible,  it  being  useless  to  do  so  when 
inflammation  is  once  established.  On  the  other  hand.  Professor 
Samuel  Cooper,  Sir  Philip  Crampton,  Dease,  and  Desault  main- 
tain that  in  fractures  of  the  skull  with  depression,  whether  it  be 
compound  or  not,  no  attempt  should  be  made  to  elevate  the 
depressed  bone,  unless  very  decided  symptoms  be  present  of 
compression  or  irritation  of  the  brain ;  and  that  they  have  seen 
Qiany  cases  terminate  favourably  without  the  use  of  the  trephine. 

I  think  that  in  all  such  cases,  whether  there  be  symptoms  of 
compression  or  not,  the  veterinary  surgeon  should  not  hesitate 
to  elevate  the  depressed  bone  at  once ;  by  not  doing  so,  he  runs 
the  risk  of  losing  his  patient  by  the  inflammatory  process  setting 
in,  when  all  chance  will  be  gone.  This  is  imperative  where  the 
depression  is  exposed  in  consequence  of  a  wound  in  the  soft 
parts,  whether  there  be  any  signs  of  mischief  to  the  brain  or 
not ;  but  if  there  be  depression  without  wound,  and  no  signs  of 
compression,  let  him  make  no  such  wound  by  operation. 

In  ponies  that  work  in  coal-pits  this  is  a  very  frequent  form  of 
fracture,  arising  from  the  tunnels  being  made  so  low  that  the 
animals  are  continually  striking  their  heads  against  the  roof.  The 
force  of  the  blows  is  here  merely  strong  enough  to  break  the  skin 
and  the  surface  of  the  bony  crest.  It  is  my  opinion  that  in  some 
cases  the  detached  pieces  of  bone  result  from  the  continual  blows 
producing  necrosis.  It  is  lamentable  to  think  that  these  poor  ani- 
mals are  worked  from  week  to  week,  and  month  to  month,  without 
an  effort  being  made  to  prevent  or  cure  such  injuries.  I  have 
seen  the  skin  of  the  forelock  detached  for  several  inches — easily 
raised  up  as  a  flap — swollen,  inflamed,  with  an  ugly,  unhealthy 
wound  underneath  it,  containing  several  pieces  of  necrosed  bone, 


FRACTURES  OF  THE  CRANIAL  BONES.  109 

causing  the  poor  brute  to  be  nearly  mad  with  pain,  and  danger- 
ous when  any  one  approached  its  head.  In  all  such  cases  the 
proper  treatment  is  to  remove  all  loose  fragments  of  bone,  scrape 
the  surface  of  the  crest,  if  in  a  necrosed  condition,  dress  with  the 
dilute  acid  already  recommended,  and  bring  the  flap  into  its 
proper  position,  retaining  it  there  by  folds  of  wet  cloth  properly 
adjusted  upon  the  ears  and  poll.  Sutures  or  plasters  should  not 
be  used,  as  they  prevent  the  escape  of  any  pus  that  may  form. 

A  form  of  bridle  now  in  use  at  the  pits  belonging  to  the 
Bowling  Iron  Company,  near  Bradford,  is  the  best  and  most 
effectual  preventive  that  I  have  seen.  It  consists  of  a  plain 
bridle,  having  a  piece  of  strong  harness  leather  extending  over, 
and  covering  the  forehead  and  poll,  from  about  two  inches 
above  the  eyes  to  a  distance  of  two  or  three  inches  behind  the 
ears,  pierced  with  holes  for  the  ears,  and  properly  adjusted  to 
the  peculiarity  of  each  head.  After  the  adoption  of  this  simple 
contrivance,  broken  heads  did  not  again  occur.  It  must  be 
kept  pliable  by  frequent  oiling,  or  it  is  apt  to  become  hardened, 
and  to  cause  irritation  at  the  base  of  the  ears. 


CONCUSSION  OF  THE  BRAIN. 

This  is  produced  by  a  blow,  or  a  fall  upon  the  skull  itself,  or 
a  fall  upon  the  nose,  by  which  a  sudden  shock  is  communicated 
to  the  brain  throusrh  the  medium  of  the  facial  bones.     In  this 

o 

way  cases  have  been  recorded  of  fracture  of  the  ethmoid  bone. 
Its  symptoms  are  arranged  in  three  stages — 1st.  Collapse ; 
2d.  Eeaction  ;  Sd.  Inflammation  of  the  brain. 

First  Stage,  or  Collapse. — In  many  instances,  the  functions  of 
the  brain  and  organs  of  sense  are  suspended,  so  that  conscious- 
ness is  entirely  lost,  with  complete  insensibility  to  external 
impressions ;  common  sensation  and  voluntary  motion  are  also 
lost  for  the  time ;  this  loss  is  often  so  great  that  the  animal 
gives  no  indication  of  pain  when  pricked  with  a  pin  or  other 
sharp  instrument ;  lies  motionless  upon  the  ground,  or  makes 
a  few  faint  struggles  with  the  limbs ;  but  is  altogether  with- 
out the  ability  of  combining  the  action  of  the  muscles,  so  as 
to  perform  any  particular  movement.  The  extremities,  and 
surface  of  the  body  generally,  are  cold,  the  respiratory  move- 
ments feeble,  but  not  usually  stertorous;  the  pulse  is  weak, 


110  PARTICULAR  FRACTURES. 

fluttering,  and  perhaps  intermittent ;  the  pupils  are  dilated  if 
the  concussion  be  very  severe,  but  they  will  usually  contract  on 
the  application  of  a  light,  showing  that  the  retina  is  not  per- 
fectly insensible.  If  the  concussion  be  slight,  the  pupils  will 
be  found  contracted,  or  possibly  one  pupil  may  be  contracted 
and  the  other  dilated.  These  symptoms  may  change  into  the 
second  stage,  or  into  those  of  compression,  or  they  may  ter- 
minate fatally  without  any  other  change. 

Second  Stage. — The  insensibility  is  diminished,  sensation  and 
volition  are  partly  restored,  but  ordinary  impressions  produce 
little  effect,  and  the  animal  lies  in  a  kind  of  sleep,  although  it 
is  possible  to  rouse  him  for  a  moment  by  speaking  loudly 
or  harshly ;  pricking  by  a  pin  causes  him  to  show  feeble 
signs  of  pain ;  there  are  occasional  signs  of  restlessness ;  the 
pulse  and  circulation  are  more  vigorous ;  the  skin  and  the 
extremities  become  warm  by  degrees  ;  and  the  animal  will  now 
and  then  make  efforts  to  rise,  which  always  produces  an 
accelerated  condition  of  the  pulse,  with  loud  beating  of  the 
heart.  These  symptoms  may  subside,  or  may  pass  on  to  the 
third  stage,  namely,  that  of  pure  inflammation  of  the  brain,  with 
throbbing  of  the  carotids  and  vessels  of  the  head,  injected  con- 
junctivse,  suffusion  of  tears,  intolerance  of  light  and  sound, 
watchfulness,  restlessness  and  delirium,  with  strong  quick  pulse, 
heat  and  dryness  of  the  skin,  diminution  of  the  secretions,  and 
other  symptoms  of  irritative  fever.  These  symptoms  may  yield 
to  treatment,  which  must  be  prompt  to  be  effectual,  or  they 
may  pass  on  to  those  of  compression,  and  prove  fatal 


DIFFERENT  WAYS  IN  WHICH  CONCUSSION  PROVES  FATAL. 

By  careful  experiments,  the  whole  of  the  brain  and  spinal 
cord  have  been  removed,  and  so  long  as  artificial  respiration 
was  kept  up,  the  action  of  the  heart  continued  for  some  hours. 
From  these  experiments  it  has  been  concluded  that  the  action 
of  the  heart  is  independent  of  the  brain  and  spinal  cord.  But 
it  has  also  been  discovered  that  when  any  sudden  injury,  such 
as  a  violent  concussion,  is  produced  on  a  part  of  the  brain  or 
spinal  cord,  an  immediate  and  great  depression,  or  complete 
suspension,  of  the  action  of  the  heart  is  the  result.  From  this 
it  is  concluded  that  a  sudden  injury  of  the  nervous  centres. 


CONCUSSION.  Ill 

such  as  violent  and  sudden  concussion,  suspends  the  action  of 
the  heart,  and  thus  proves  fatal  by  syncope  or  death  beginning 
at  the  heart.  The  vital  powers  of  the  heart  seem  to  be  destroyed, 
for  when  the  chest  is  opened  immediately  after  death,  it  is 
impossible  to  excite  contraction  of  that  organ. 

The  difference  between  the  effects  of  concussion  and  a  wound 
of  the  brain  is  very  remarkable.  Mayo  observes  on  this  sub- 
ject—"A  great  part  of  the  brain  of  an  animal  may  be  gently 
and  quietly  sliced  away  with  little  or  no  effect ;  but  if  ever  so 
small  a  portion  be  suddenly  crushed,  the  heart  stops  directly." 

Again,  from  the  experiments  of  Chossart  and  others,  there 
appears  some  variety  of  opinion  as  to  the  part  of  the  circula- 
tion chiefly  affected  by  certain  injuries  of  the  nervous  centres. 
In  certain  injuries  of  the  brain  and  spinal  cord,  Chossart  found 
that  the  capillary  circulation  appeared  for  a  time  to  be  more 
affected  than  the  heart's  action ;  but  still  it  is  by  failure  of  the 
circulation  that  such  injuries  ultimately  prove  fatal.  It  is  only 
by  such  knowledge  as  this  that  the  practitioner  can  be  guided 
to  rational  and  scientific  treatment.  A  peculiar  fact  may  be 
introduced  here,  as  exemplifying  a  lesion  which  occurs  very 
frequently  after  the  operation  of  pithing  (dividing  the  spinal 
cord  between  the  occiput  and  atlas,  or  atlas  and  dentata), 
namely,  rupture  of  the  vena  azygos. 

In  some  cases,  when  death  occurs  from  concussion,  the  heart 
is  found  quite  empty,  a  condition  that  is  not  easily  accounted 
for.  In  other  cases  it  is  distended;  but  the  distinguishing 
peculiarity  is,  that  there  is  no  difference  in  the  quantity  of  blood 
in  its  right  and  left  sides. 

"  We  may  sum  up  by  stating  "  (says  Pirrie)  "  that  when  con- 
cussion proves  fatal  in  the  first  stage,  it  is  by  failure  of  the 
action  of  the  heart,  which  is  sometimes  instantaneous,  some- 
times gradually  increasing  to  a  fatal  termination ;  and  some- 
times there  is  a  very  partial  reaction,  and  then  a  second  failure 
of  the  organs  of  circulation,  which  proves  fatal." — (Pirrie, 
Principles  and  Practice  of  Surgery?) 

Bearing  these  facts  in  remembrance,  the  practitioner  will 
watch  the  state  of  the  organs  of  circulation  with  care  and 
anxiety.  Another  way  in  which  concussion  proves  fatal  is  by 
compression,  arising  from  extravasation  of  blood,  serous  effusion, 
or  the  formation  of  pus. 


112  PAKTICULAK  FKACTURES. 


POST  MORTEM  APPEARANCES. 

These  will  vary  according  to  the  length  of  time  intervening 
between  the  injury  and  the  death  of  the  patient.  In  cases  that 
are  almost  instantaneously  fatal,  laceration  of  the  brain  is  often 
observed.  In  other  cases  the  dura  mater  is  separated  from  the 
inner  plate ;  and  this  is  a  very  common  condition.  Again,  the 
venous  sinuses  are  found  lacerated ;  and,  in  other  cases,  the  con- 
cussion proves  fatal  without  any  lesion  being  visible  either  in 
the  brain  or  its  membranes. 

In  the  cases  where  death  occurs  at  a  more  advanced  stage, 
traces  of  inflammation  will  be  present,  such  as  increased  vascu- 
larity of  the  membranes,  small  specks  of  blood  in  the  brain, 
various  kinds  of  inflammatory  products,  lymph,  serum,  pus,  or  a 
combination  of  these  conditions. 

It  has  been  supposed,  where  no  lesion  is  apparent,  that  the 
sudden  shock  disturbing  the  circulation  of  the  brain  is  the  cause 
of  death;  and,  again,  that  the  structures  are  injured,  and  the 
injury  not  discoverable  by  dissection.  Others  think  that  the 
fatal  result  arises  from  condensation  of  the  brain.  One  writer, 
Mr.  Liston,  says — "  When  a  blow  is  inflicted  on  the  skull,  only 
a  slight  commotion  of  the  brain  is  induced  ;  the  cranial  contents 
are,  as  it  were,  slightly  jumbled,  and  a  temporary  and  trifling 
disturbance  of  its  functions  follows.  When,  however,  the 
stroke  is  more  severe,  the  brain  is  separated  from  its  cranial 
attachments,  both  at  the  point  struck  and  at  the  part  directly 
opposite.  It  is  thrown  upon  itself  towards  its  centre ;  its  sub- 
stance is  thereby  condensed,  its  diameter  in  the  direction  of  the 
impulse  diminished,  and  a  separation  between  the  brain  and  the 
cranium  is  formed  at  each  extremity  of  that  diameter." 

By  post  mortem  examinations  it  has  been  ascertained  that 
condensation  of  the  substance  of  the  brain  does  exist  in  cases  of 
severe  concussion.  Such  condensation  may  be  sufficient  to 
cause  instantaneous  extinction  of  life;  or  the  brain  may 
gradually  resume  its  former  condition,  or  only  with  such  incited 
action  as  may  be  required  to  reunite  the  dura  mater  with  the 
inner  table  of  the  skull. 

Treatment. — In  the  first  stage,  when  the  symptoms  of  depres- 
sion are  very  great,  and  there  is  danger  of  death  from  failure 
of  the  heart's  action,  stimulants,  as  ammonia,   should  be  ad- 


CONCUSSION.  113 

ministered,  care  being  first  taken  to  ascertain  whether  the  power 
of  deglutition  be  present  or  not.  If  the  power  of  swallowing 
be  lost,  medicine  can  still  be  conveniently  given  in  the  form  of 
a  ball,  which  should  be  well  oiled,  and  pushed  as  far  as  possible 
into  the  pharynx.  From  the  great  danger  of  reaction  being 
excessive,  and  the  tendency  of  inflammation  to  succeed,  the 
administration  of  alcoholic  stimulants  will  be  improper,  and 
means  must  be  employed  to  restore  the  circulations  that  do  not 
tend  to  have  a  permanent  effect.  The  animal  is  to  be  covered 
with  warm  clothing,  and  even  heated  blankets  can  be  applied 
to  the  extremities  and  surface  of  the  body  with  great  advantage. 
It  is  thought  by  some  of  the  most  eminent  of  surgeons  that 
very  little  beyond  this  should  be  done  in  the  first  stage,  as 
the  period  of  depression  tends  to  diminish  the  danger  of  haemorr- 
hage in  case  the  brain  should  be  wounded;  and  that  if  the 
circulation  be  artificially  excited,  there  is  much  danger  of  com- 
pression from  extravasation  of  blood.  But  whilst  the  indis- 
criminate administration  of  stimulants  is  thus  condemned,  the 
abstraction  of  blood  would  be  also  highly  improper,  and  most 
injudicious,  as  the  vital  depression  already  existing  would  be 
increased  to  such  an  extent  as  to  destroy  any  chance  that 
might  remain  of  saving  the  patient's  life.  In  the  majority  of 
cases,  however,  it  would  be  useless  to  attempt  bleeding,  as  the 
blood  would  not  flow  until  reaction  had  commenced,  and  then 
the  loss  of  the  vital  fluid  would  probably  kill  the  patient. 

In  the  second  stage,  or  return  of  sensibility,  the  warm  cloth- 
ing, &c.  should  be  removed,  the  patient  placed  in  a  cool,  dark, 
and  quiet  loose  box,  cold  applied  to  the  head,  a  full  dose  of  pur- 
gative medicine  given,  and  the  diet  to  be  of  the  simplest  kind, 
such  as  bran  water.  If  there  be  a  desire  on  the  part  of  the  animal 
to  eat  his  straw,  he  should  be  bedded  with  sawdust,  strict  watch 
being  kept  upon  him ;  and  if  symptoms  of  excitement  be  observed, 
it  may  be  advisable  to  bleed,  if  the  state  of  the  pulse  warrants 
such  a  proceeding ;  but  if  the  practitioner  thinks  bleeding  unad- 
visable,  the  heart's  action  may  be  moderated  by  aconite,  the 
most  valuable  of  all  sedatives  in  veterinary  practice.  It  is  given 
in  small  doses,  from  seven  to  ten  drops  of  Fleming's  tincture,  as 
a  larger  dose  is  apt  to  produce  some  amount  of  preliminary  ex- 
citement. Before  administering  even  this  most  simple  of  seda- 
tives, the  practitioner  must  well  consider  his  ease ;  for  sedative 

I 


114  PARTICULAR  FRACTURES. 

remedies  may  produce  an  impression  on  the  nervous  system  pre- 
disposing it  to  inflammatory  action. 

In  the  third  stage,  or  that  of  inflammation  of  the  brain,  there 
must  be  a  prompt  abstraction  of  blood,  the  administration  of  a 
full  cathartic,  and,  when  the  delirium  of  the  animal  will  allow 
the  attendant  to  handle,  him,  cold  must  be  applied  to  the  head 
bv  means  of  cold  water,  or  even  ice. 

It  is  necessary  that  the  abstraction  of  blood  should  not  be 
carried  too  far,  for  if  there  be  laceration  of  the  brain,  the  consti- 
tution may  be  so  weakened  by  such  bleeding  as  to  prevent  the 
process  of  repair  being  set  up  in  the  lesion. 

The  signs  of  the  inflammatory  condition  may  subside,  or  may 
be  succeeded  by  others,  denoting  that  compression  of  the  brain 
by  blood,  serum,  or  pus,  is  present ;  and  in  well-marked  cases 
there  is  insensibility  and  unconsciousness,  as  in  the  first  stage ; 
— with  this  difference,  that  in  mere  concussion  the  symptoms 
pass  off,  and  even  during  its  continuance  there  are  occasional  fits 
of  restlessness ;  but  during  compression  they  are  constant  whilst 
the  cause  is  in  operation.  The  retina  is  perfectly  insensible,  the 
iris  motionless,  the  pupil  dilated,  the  respiration  slow,  difficult, 
and  stertorous ;  the  animal  may  breathe  through  the  mouth,  the 
tongue  hanging  out ;  and  the  air  puffs  out  the  checks.  A  cow 
in  the  comatose  stage  of  milk  fever  will  present  a  familiar 
example  of  this.  Stertorous  breathing  arises  from  the  relaxation 
of  the  velum  palati,  and  of  the  laryngeal  and  pharyngeal  muscles. 
This  relaxation  prevents  the  free  passage  of  the  air,  and  gives 
rise  to  the  noise  in  breathing  called  stertor. 

This  condition  of  the  animal  is  that  of  complete  coma,  and 
death  is  caused  by  asphyxia  resulting  from  paralysis  of  the 
muscles  of  respiration;  and  from  the  insensibility  destroying 
the  feeling  of  the  want  of  air,  which  in  ordinary  circumstances 
excites  the  respiratory  movements. 

The  pulse  is  generally  slow,  full,  and  labouring,  as  the  action 
of  the  heart  does  not  seem,  as  in  concussion,  to  be  affected 
directly,  but  to  become  impeded,  from  the  obstruction  of  the  cir- 
culation through  the  pulmonary  vessels. 

There  is  loss  of  the  power  of  swallowing,  from  paralysis  of  the 
muscles  of  deglutition ;  the  action  of  the  bowels  is  arr-ested,  from 
their  walls  being  affected  by  the  general  paralysis ;  the  sphincter 
ani  is  relaxed,  and  faeces  are  passed  involuntarily ;  the  bladder  is 


CONCUSSION.  115 

paralyzed,  and  cannot  expel  the  urine,  which  sometimes  dribbles 
off  in  small  quantities.  This  indicates  a  state  of  great  disten- 
sion of  the  bladder,  and  that  the  urine  forces  its  neck  to  such  an 
extent  as  to  allow  the  overflow  of  its  contents. 

Some  cases  are  characterised  by  convulsive  twitchings,  rapid, 
feeble  pulse,  and  hurried  respiration; — symptoms  believed  to 
denote  wound  of  the  brain  rather  than  concussion. 

It  has  been  discovered  by  dissections  that  haemorrhage  from 
concussion  may  occur  in  any  of  the  five  following  situations  : — 
1st.  Between  the  cranium  and  dura  mater  ;  2d.  Under  the  dura 
mater  into  the  cavity  of  the  tunica  arachnoidea ;  od.  Between  the 
tunica  arachnoidea  and  pia  mater ;  AtJi.  Between  the  pia  mater 
and  brain  ;  and  5t7i.  Into  the  substance  of  the  brain  itself. 

The  method  of  trephining  for  injuries  of  the  cranium  is  de- 
scribed as  follows  by  the  great  surgeon  Syme  : — "  If  the  bone 
be  not  sufficiently  exposed  by  the  original  injury,  a  crucial  or 
triangular  incision  must  be  made  through  the  scalp,  the  flaps 
of  which  are  to  be  dissected  back.  The  pericranium  is  next 
scraped  off  sufficiently  to  prevent  it  from  impeding  the  teeth  of 
the  saw,  which  i^  applied  at  first  with  its  centre  pin,  to  keep  it 
steady,  and  afterwards,  when  a  groove  has  been  formed,  this 
obstacle  to  its  progress  is  removed.  The  sawing  must  be  con- 
ducted cautiously,  as  the  skull  is  not  always  equally  thick, 
and  is  often  throughout  very  thin,  with  hardly  any  perceptible 
diploe.  A  toothpick  or  probe  should  be  introduced  from  time 
to  time,  to  ascertain  whether  or  not  the  bone  be  perforated  at 
any  part  of  the  circle,  and  when  the  whole  seems  to  be  nearly 
cut  through,  an  elevator  or  forceps  may  be  employed  to  raise  the 
detaclied  piece.  If  circumstances  appear  to  require  the  removal 
of  more  bone,  the  same  means  are  to  be  repeated,  or  the  process 
may  be  accelerated,  if  the  portion  be  extensive,  by  Hey's  saw, 
as  it  is  usually  called,  which  proves  convenient  for  connecting 
the  circular  apertures  together,  so  as  to  separate  at  once  a 
large  portion  of  cranium.  After  the  operation  the  wound  is 
to  be  lightly  dressed,  and  the  general  treatment  conducted  with 
the  view  of  checking  any  tendency  to  inflammatory  action." 

After  the  operation,  well-regulated  pressure  should  be  applied 
to  the  part  by  means  of  pads  of  tow  and  bandages ;  if  this  is 
not  done,  a  tumour  is  apt  to  make  its  appearance,  which  consists 
of  a  protrusion  of  the  brain,  and  is  termed — 


116  PARTICULAR  FRACTURES. 

HERNIA  CEREBRI,  OR  FUNGUS  OF  THE  BRAIN. 

This  is  very  similar  in  appearance  to  a  mushroom,  the  ex- 
panded portion  overhanging  the  skull,  while  the  narrow  part 
projects  through  the  opening  in  the  bone,  and  is  connected  with 
the  brain.  It  is  elastic  and  compressible,  destitute  of  sensi- 
bility, of  very  rapid  growth,  and  when  cut  into,  is  found  to 
consist  of  cerebral  matter  and  clots  of  blood. 

Treatment. — All  that  can  be  done  is  to  cut  the  tumour  clean 
off,  and  apply  pressure  by  wet  pads,  and  prevent  all  excitement. 
The  tumour  has  a  great  tendency  to  grow  afresh,  and,  as  a 
rule,  a  fatal  termination  may  be  looked  for. 


CHAPTEK  VL 

PARTICULAR  FRACTURES — CO  71  ti/lU  cd. 

FRACTURES    OP    THE    VERTEBRA — ON    BROKEN    BACK — FRACTURE  OF 
THE   SACRAL   AND   COCCYGEAL   BONES — FRACTURE  OF  THE  PELVIC 

BONES FRACTURE      OF      THE    FEMUR FRACTURE    OF    TIBIA 

FRACTURE  OF  THE  TARSAL  AND  METATARSAL  BONES. 

FRACTURES  OF  THE  VERTEBRA. 

A  FRACTURED  vertebra,  above  the  origin  of  the  phrenic  nerve, 
with  displacement  of  the  fragments,  produces  death,  and  is  not 
discovered  until  a  jpost  mortem  examination  be  made.  This 
nerve  is  formed  by  the  union  of  branches  from  the  fourth,  fifth, 
and  sixth  cervical  nerves,  and  conveys  motor  power  to  the 
diaphragm.  "When  this  power  is  cut  off,  death  results  from 
paralysis  of  this  great  respiratory  muscle.  It  is  very  true,  as 
can  be  seen  after  an  animal  is  "  pithed,"  that  respiration  goes 
on  for  a  short  time,  but  it  is  performed  with  great  difficulty, 
and  seemingly  without  the  aid  of  the  diaphragm,  and  becomes 
slower  and  slower,  until  it  finally  ceases  altogether. 

The  transverse  processes  of  the  cervical  vertebrae  are  some- 
times fractured,  and  by  pressing  upon  the  cervical  nerve  in  the 
immediate  neighbourhood,  cause  more  or  less  paralysis  of  the 
cervical  muscles  supplied  by  that  nerve,  producing  what  is  com- 
monly termed  wry  neck — that  is,  a^  twisted  neck,  the  head  being 
turned  from  the  seat  of  the  injury.  I  had  once  under  my  care 
a  case  of  this  kind,  where  the  fractured  bone  had  become  carious, 
communicating  with  the  surface  by  means  of  fistulous  openings. 
The  horse  had  fallen,  months  before  he  was  seen  by  me ;  the  neck 
had  been  persistently  bent  from  the  beginning,  and  attempts 
had  been  made  to  straighten  it,  but  without  success ;  the  soft 
parts  commenced  to  swell,  and  eventually  abscesses  formed  suc- 
cessively, and  were  discharging  the  offensive  pus  peculiar  to  dis- 
eased bone.     The  use  of  the  probe  did  not  enable  me  to  form 


118  PARTICULAR  FRACTURES. 

any  definite  conclusion ;  but  feeling  sure  there  was  detached 
bone,  the  wounds  were  opened  up,  a  piece  of  fractured  bone  in 
a  necrosed  condition  removed,  and  the  wound  brought  together 
by  suture.  The  process  of  healing  was  rapid,  and  no  more  ab- 
scesses formed,  but  the  neck  never  became  quite  straight.  There 
was  certainly  a  great  improvement,  and  the  animal  worked  for 
years  afterwards.  The  spinous  processes  of  the  dorsal  vertebrae 
are  the  seat  of  fracture,  and  when  this  occurs,  the  detached 
fragments  cause  what  is  known  as  "  fistulous  withers ;"  the 
sinuses  must  be  explored,  and  the  fragments  removed.  Occa- 
sionally it  is  found  that  the  tuberous  ends  of  the  spines  are 
merely  bruised,  and  are  in  a  state  of  caries  or  necrosis  from  the 
violence.  The  treatment  proper  for  this  kind  of  injury  is  the 
careful  scraping  away  of  the  diseased  surface. 


ON  BROKEN  BACK. 

Fracture  of  the  spine  is  of  two  kinds : — 

1.  Fracture  without  displacement. 

2.  Fracture  with  displacement. 

Both  of  these  fractures  may  be  exactly  similar  in  situation  and 
extent,  and  they  may  involve  either  the  body  of  a  vertebra,  or 
its  arch,  or  both. 

1st.  Fracture  without  displacement  generally  occurs  in  the 
dorsal  vertebra.  In  our  dissecting  room  it  is  revealed  that 
broken  backs  are  no  uncommon  occurrences,  and  that  the  frac- 
tures have  united  without  the  animal  having  apparently  shown 
any  symptoms  during  life ;  the  bones  having  been  kept  in  the 
proper  position  by  their  ligamentous  connections,  and  the  spinal 
cord  never  havinsj  been  interfered  with. 

In  practice,  however,  cases  are  sometimes  seen  where,  after  a 
severe  fall,  there  is  partial  paralysis,  showing  clearly  that  the 
medulla  spinalis  is  more  or  less  involved  in  the  injury ;  and  as 
illustrations  of  this,  and  indicative  of  the  proper  treatment  of 
such  injuries,  I  will  briefly  relate  two  cases  that  occurred  in  my 
practice  while  resident  in  Bradford. 

The  first  case,  a  truck  horse  belonging  to  the  Lancashire  and 
Yorkshire  Eailway  Company,  was  knocked  down  with  great 
force  by  a  passing  truck.  The  force  was  so  great  as  to  cause  the 
horse  to  roll  over  two  or  three  times  on  the  ground ;  he  got  up 


BROKEN  BACK.  119 

with  difficulty,  and  was,  when  examined  a  very  short  time  after- 
wards, found  to  present  symptoms  of  paralysis  of  both  posterior 
extremities.  There  was  knuckling  over  at  the  fetlocks  when 
standing,  difficulty  in  moving  the  legs  forward,  the  peculiar 
plaiting  or  crossing  of  the  legs  which  is  observable  in  partial 
paralysis,  and  the  rolling,  uncertain  gait.  Nothing  could  be 
found  upon  examination. 

The  treatment  consisted  of  quietude,  rest,  dose  of  physic,  and 
hot  fomentations  to  the  loins.  In  about  six  weeks  the  paralytic 
symptoms  diminished,  and  in  about  ten  weeks  the  horse  was  at 
work  again,  and  continued  to  work  as  a  truck  horse  for  four 
years  afterwards,  when,  in  consequence  of  a  lameness  in  one  of 
his  feet,  he  was  turned  out  to  grass.  Upon  being  let  loose  in 
the  field,  he  commenced  galloping,  and  going  down  a  hill,  his 
hind  feet  slipped  from  under  him ;  he  fell  heavily,  was  unable  to 
rise,  and  had  to  be  destroyed. 

The  post  mortem  examination  revealed  the  seat  of  the  old 
fracture,  the  third  lumbar  vertebra;  the  process  of  anchylosis 
having  extended  to  the  rest  of  the  lumbar  vertebrae,  the  whole 
being  united  as  one  bone ;  and  there  was  a  recent  fracture  of  the 
fourth,  with  displacement  and  pressure  on  the  cord. 

The  second  case  was  a  high-spirited  saddle  horse,  which  was 
suddenly  thrown  upon  his  haunches  by  a  strong  check  being 
given  him  by  his  rider,  who  was  using  a  dreadfully  severe  bit. 
After  he  was  thrown  on  his  haunches,  he  recovered  with  some 
difficulty,  and  walked,  partially  paralyzed,  a  distance  of  seven 
miles  into  Bradford,  when  he  was  seen  presenting  symptoms 
similar  to  case  No.  1.  The  same  treatment  was  adopted;  but 
unfortunately  the  owner  listened  to  the  voice  of  a  farrier  in  the 
town,  who  asked  to  be  allowed  to  put  the  horse  in  slings.  When 
the  poor  animal  felt  the  support  of  the  slings,  he  lay,  as  horses 
will  do  while  on  the  slings,  with  the  legs  in  a  semi-flexed  posi- 
tion, and  his  weight  thrown  upon  the  trunk.  As  a  natural  result, 
the  back  arched  upwards,  and  immediately  there  was  displace- 
ment of  the  fractured  vertebra,  and  total  paralysis  of  both  hind 
limbs.  When  seen  again  by  me,  he  was  greatly  excited  and 
very  restless,  and  was  ordered  out  of  the  slings.  When  the  slings 
were  removed,  the  hind  limbs  were  quite  unable  to  support 
him ;  he  therefore  went  down,  and,  being  a  high-mettled  horse, 
commenced  to  fight  and  struggle  with  the  fore  legs,  to  knock  his 


120  "  PARTICULAK  FRACTURES. 

head  against  the  wall,  manger,  &c.,  bruising  himself  in  a  fearful 
manner.  Seeing  that  he  was  in  great  agony,  and  the  chance  of 
recovery  now  hopeless,  he  was  destroyed.  The  i^ost  mortem 
examination  revealed  fracture  through  the  body  of  the  last  dorsal 
vertebra.  I  am  satisfied  that  this  case  would  have  eventually 
recovered  if  he  had  not  been  interfered  with,  as  there  was  no 
fever ;  the  appetite  was  good,  and  the  animal  cheerful  before  the 
slings  were  used. 

Fractures  of  the  spine  occur  during  the  performance  of  a 
surgical  operation  when  the  animal  is  cast. 

Let  it  be  here  clearly  understood  that  such  fractures  rarely  if 
ever  occur  during  the  fall,  but  when  the  horse  is  down  on  the 
ground,  and  struggling  from  the  pain  of  the  operation,  or  from 
the  inconvenience  of  his  position.  Broken  backs  during  the 
performance  of  operations  are  much  more  common  in  Scotland 
than  in  England;  this  arises  from  the  different  methods  in 
which  horses  are  cast.  The  late  Professor  Dick  used  to  say : — 
"  Fracture  of  the  body  of  the  bone  (a  vertebra),  while  the  horse 
is  under  operation,  sometimes  takes  place;  this  is  to  be  pre- 
vented by  placing  a  back  rope  on  the  horse  before  he  is  cast, 
and  then  it  is  to  be  tied  round  the  legs  and  back,  to  prevent  the 
animal  struggling  while  down."  ^ 

Now,  with  all  due  deference  to  the  teaching  of  the  late  Pro- 
fessor, I  must  here  say  that  the  immense  number  of  broken 
backs  which  we  hear  of  in  Scotland  arises  from  the  circumstance 
that  the  animal  is  fastened  so  that  he  cannot  struggle ;  whereas 
he  should  be  allowed  more  or  less  freedom  of  motion  while  he  is 
confined  in  the  hobbles. 

By  using  the  " hack  rope"  as  recommended  by  Professor  Dick, 
the  great  muscles  of  the  loins,  quarters,  and  thighs  are  made  to 
act  upon  two  fixed  points,  namely,  the  spinal  column  on  the  one 
hand,  and  the  extremities  on  the  other;  and  when  muscular 
force  is  exerted  to  such  an  extent  as  we  see  when  an  animal  is 
down,  one  of  the  points  is  likely  to  give  way ;  whereas,  if  the 
extremities  are  allowed  a  little  freedom,  the  force  is  expended  in 
moving  them,  and  there  will  be  but  little  or  no  danger  of  a 
broken  back. 

If  it  were  possible,  by  so  fixing  the  animal,  to  destroy  mus- 
cular action,  it  would  be  a  great  convenience  to  the  operator; 

*  Frcm  Notes  of  Professor  Dick's  Lectures,  delivered  during  Session  1855-6. 


BROKEN  BACK.  121 

but  tlie  muscular  force  remains  in  spite  of  all  the  tying  down 
that  can  be  done  with  ropes,  and  bones  will  as  surely  be 
broken. 

I  have  always  held  the  opinion  now  laid  down ;  and  although 
it  might  have  been  shaken  during  my  first  college  days,  it 
returned  to  me  with  greater  force  from  seeing  a  horse  break 
his  back  while  tied  down  with  the  back  rope.  When  I  first 
promulgated  this  idea,  during  my  first  course  of  lectures  at  the 
Edinburgh  Veterinary  College,  the  majority  of  the  senior  stu- 
dents thought  my  teaching  absurd ;  and  to  prove  it  so  one  of 
them  purchased  a  subject  for  dissection,  and  before  destroying 
him,  had  him  cast  for  the  instruction  of  his  fellow-students, 
and  secured  so  firmly  that  he  could  not  break  his  back,  as  he 
said ;  but,  wonderful  to  relate,  the  animal  tried  to  struggle,  the 
back  was  broken,  and  he  rose  no  more. 

It  is  a  creneral  belief  amonoj  veterinarians  that  a  horse  with  a 
broken  back  cannot  move  his  tail ;  but  this  is  liable  to  excep- 
tions, and  it  will  be  found  that  complete  paralysis  from  fracture 
will  be  accompanied  at  first  by  movements  of  the  tail.  To  take 
this  symptom  as  being  diagnostic  of  fracture,  and  to  conclude 
that  when  movement  of  the  tail  remains,  the  injury  is  a  sprain 
of  the  psoae  muscles,  may  lead  to  error  and  wrong  prognosis. 
Absence  of  sensibility  and  the  history  of.  the  case  are  much 
more  to  be  depended  upon. 

As  a  rule,  but  not  without  exception,  vertebrae  are  fractured 
through  their  bodies,  the  arches  remaining  intact. 


FRACTURES  OF  THE  OS  SACRUM. 

The  anterior  portion  of  the  .border  of  this  bone  is  sometimes 
fractured  by  violent  falls,  or  by  the  animal  becoming  "  cast  in 
the  stall."  It  will  be  remembered  that  the  sides  of  the  os 
sacrum  are  attached  to,  and  situated  below,  the  posterior  spinous 
process  of  the  ilium,  giving  support  and  attachment  to  the 
pelvis,  and  connecting  it  with  the  vertebra.  When  it  is  frac- 
tured, the  iliac  spine,  losing  its  support,  immediately  falls,  and 
the  highest  part  of  the  quarter  becomes  flattened,  which  can 
be  easily  seen  by  comparison  with  its  fellow  of  the  other  side. 
Examination  per  rectum  will  enable  the  practitioner  easily  to 
diagnose  the  exact  seat  of  the  injury.     I'rofessor  Dick  used  to 


122  PARTICULAR  FRACTURES. 

say  that  in  this  fracture  the  legs  bent  under  the  horse,  and  that 
this  was  its  diagnostic  sign. 

Treatment. — Slinging  and  rest;  and  as  a  rule  cases  terminate 
very  satisfactorily,  all  that  remains  being  the  flatness  of  the 
quarter. 

The  Coccygeal  Bones  are  also  liable  to  fracture,  which  may 
be  detected  by  inability  on  the  part  of  the  patient  to  raise  the 
tail,  and  by  crepitation. 

Treatment. — Strong  leather  binding  laced  around  the  tail,  ex- 
tending from  its  upper  to  its  lower  part,  proper  padding  being 
at  the  same  time  used  to  prevent  excoriation. 

The  rudimentary  spines  of  the  false  vertebrae  of  the  tail  are 
sometimes  fractured,  giving  rise  to  troublesome  sinuses. 

The  wounds  to  be  laid  open,  and  the  detached  bones  removed. 

A  comminuted  fracture  of  the  bones  of  the  tail,  with  violent 
bruising  of  the  soft  parts,  succeeded  by  inflammation,  and  even 
gangrene,  is  occasionally  seen  in  practice.  In  such,  amputation 
of  the  tail  and  removal  of  all  the  fractured  bones  must  at  once 
be  resorted  to,  or  serious  consequences  may  result,  such  as 
irritative  fever  or  tetanus. 


FRACTURE  OF  THE  PELVIC  BONES 

May  be  arranged  under  seven  heads : — 

1st.  Fracture  of  anterior  iliac  spine, 

2d.  „  of  posterior  iliac  spine. 

3d.  „  of  the  shaft  of  the  ilium. 

4:th.  „  through  the  acetabulum. 

bth.  „  into  the  foramen  ovale. 

6th.  „  through  the  symphysis  pubis. 

7th.  „  of  the  tuberosity  of  the  ischium. 

Fracture  of  Anterior  Iliac  S2nne. — This  is  the  most  common 
form  of  fracture  to  which  the  horse  and  the  cow  are  liable  ;  it  is 
generally  caused  by  falls,  or  by  the  animal  striking  this  part 
against  a  wall  or  side  of  a  doorway,  most  commonly  the  latter, 
and  chipping  off,  as  it  were,  more  or  less  of  this  prominent  part 
of  the  quarter.  It  is  not  always  attended  by  lameness,  and  is 
distinguishable  by  lateral  flatness  of  that  quarter. 

The  broken  piece  of  bone  is  drawn  inwards  and  downwards 


FRACTURE  OF  THE  PELVIC  BONES.  123 

by  the  action  of  the  abdominal  muscles  attached  to  it.  In  this 
fracture  we  find  the  method  of  repair  is  by  false  joint,  the  frac- 
tured ends  being  connected  by  a  fibrous  or  a  fibro-cartilaginous 
tissue.  This  is  due  to  the  action  of  the  muscles  attached  to  the 
fragments  keeping  them  in  a  state  of  continual  motion,  and  is 
an  example  of  arrested  development  of  the  reparative  material ; 
every  otlier  part  of  the  process  of  repair  may  be  complete  but 
that  of  ossification ;  and  the  fragments  are  held  together  by  a 
yielding  and  pliant  bond. 

There  is  very  little  treatment  necessary  in  a  case  of  this  kind. 
If  the  soft  parts  are  injured,  physic,  fomentation,  and  a  short 
rest  will  be  sufficient. 

l^ow  and  then,  however,  we  meet  with  a  case  where  no 
attempt  at  repair  is  made,  and  the  broken  fragment  or  frag- 
ments die,  or  become  necrosed,  giving  rise  to  the  formation  of 
sinuses  both  near  to  and  below  the  seat  of  injury.  In  such  a 
case  it  will  be  necessary  to  remove  the  irritating  fragments, 
and  treat  according  to  the  rules  already  laid  down. 

Although  a  horse  that  is  flat  in  the  quarter  may  not  be  un- 
sound, yet  he  is  of  less  value  in  the  market  than  if  he  were  all 
right.  It  is,  therefore,  of  importance  that  the  practitioner  should 
compare  the  two  quarters  of  every  horse  he  examines  as  to 
soundness;  and  this  should  be  done  by  standing  behind  the 
horse  examined. 

The  next  four  forms  of  fracture  of  the  pelvis  present  ex- 
ternally symptoms  similar  to  each  other — namely,  a  flatness 
of  the  surface  of  the  quarter,  and  lameness,  with  great  difficulty 
in  extending  the  foot,  particularly  if  the  toe  strikes  the  ground. 

The  exact  seat  of  the  fracture  is  to  be  determined  by  an 
examination  per  rectum,  when  movement  of  the  limb  will 
indicate  this  by  crepitation  and  motion  in  the  part.  As  a  rule, 
if  the  patient  be  laid,  he  will  have  great  difficulty  in  rising ;  if 
through  the  acetabulum,  he  will  scarcely  be  able  to  rise  even 
with  assistance ;  and  when  he  is  up,  the  limb  is  unable  to  bear 
any  weight,  and  it  will  be  shorter  than  its  fellow,  from  the  head 
of  the  femur  being  drawn  upwards  on  to  the  dorsum  of  the 
ilium  by  the  action  of  the  gluteal  muscles.  The  trochanter  will 
be  felt  farther  back  and  higher  up  than  usual ;  the  toe  will  be 
turned  inwards,  and  rest  upon  the  coronet  of  the  opposite  foot. 
Fracture  through   the   acetabulum  is  the  only  one  where  re- 


124  PARTICULAR  FRACTURES. 

covery  is  hopeless ;  all  the  others  being  curable,  provided  the 
fracture  is  not  due  to  previous  disease  of  the  bones,  namely — 
fragilitus  or  mollities  ossium. 

Fracture  of  the  shaft,  or  into  the  foramen  ovale,  may  occur 
without  immediate  displacement,  and  the  animal  show  no  sign 
of  lameness  until  such  displacement  occurs. 

In  a  case  which  once  came  under  my  observation,  it  was 
found  that  the  fracture  was  of  several  weeks'  standing,  although 
the  horse  had  worked  perfectly  sound  in  a  carriage  up  to  the 
time  of  the  displacement.^ 

The  fracture  arose  from  mollities  ossium,  which  was  present 
also  in  the  tarsal  and  other  bones ;  and  when  displacement 
occurred  the  animal  was  at  work  upon  a  level  road,  and  going 
at  ordinary  speed.  He  did  not  fall,  but  suddenly  became  very 
lame. 

It  has  been  already  stated  that  fracture  through  the  aceta- 
bulum is  hopeless,  therefore  no  time  should  be  lost  in  putting 
the  animal  out  of  pain;  but  in  the  other  forms,  the  patient 
should  be  slung,  and  in  order  to  do  something  to  keep  the  parts 
at  rest,  a  stiff  pitch-plaster  ought  to  be  applied  to  the  whole 
quarter.  Apparent  recovery  will  take  place  in  from  two  to 
three  months,  but  care  should  be  taken  not  to  put  the  animal  to 
work  too  soon. 

If  the  horse  has  to  be  moved  any  distance  after  the  occur- 
rence of  any  of  the  curable  fractures  mentioned,  his  movements 
wiU  be  made  very  much  easier  by  the  attendants  tying  a  cord 
round  the  foot  of  the  lame  limb,  to  assist  in  its  extension,  apd 
to  prevent  the  toe  coming  to  the  ground  first ;  for  it  will  be  seen 
that  if  the  toe  strike  the  ground  first,  the  patient  will  knuckle 
over  at  the  fetlock  to  a  most  alarming  degTce ;  indeed,  this 
knuckling  over  will  sometimes  be  so  great  as  to  cause  the 
animal  to  fall  to  the  ground.  Cases  of  this  kind  have  repeatedly 
occurred  in  my  experience,  and  by  the  simple  expedient  here 
mentioned — the  attendant  taking  care  to  pull  the  foot  forwards, 
and  rather  upwards  before  it  touches  the  gTOund,  so  as  to 
ensure  its  falling  flat — the  animal  has  walked  with  compara- 
tive ease. 

1  I  had  diagnosed  this  to  be  a  fracture  of  long  standing  before  he  was  destroyed, 
and  arrived  at  this  conclusion  from  the  fact  that  there  was  much  thickening  and 
indolent  swelling  to  be  felt  per  rectum. 


FRACTURE  OF  THE  PELVIC  BONES.  125 

Fracture  through  the  Syviphysis  Pubis. — This  form  of  frac- 
ture is  caused  by  the  posterior  extremities  suddenly  slipping 
outwards.  Its  symptoms  are — a  wide  straddling  gait  behind, 
the  legs  being  dragged  forwards  in  progression ;  the  feet 
wide  apart,  the  toes  turned  outwards ;  the  lameness  being 
sometimes  excessive.  Examination  per  rectum  will  enable 
the  practitioner  to  determine  the  extent  and  exact  nature  of 
the  lesion. 

Very  little  can  be  done  in  the  way  of  active  treatment.  If 
the  animal  is  not  of  much  value,  he  had  better  be  destroyed ; 
but  if  young,  or  worth  the  cost  of  keep  and  treatment,  he  may 
be  slung,  the  limbs  pulled  as  near  to  each  other  as  possible,  and 
kept  in  that  position  by  being  fastened  with  a  strap  above 
the  hocks.  In  two  or  three  months  a  fair  recovery  may  be 
expected. 

Fractures  of  Tuberosity  of  Ischium  arise  from  the  patient 
falling  backwards  upon  the  buttocks,  either  from  a  slip 
whilst  backing,  or  by  being  pulled  over  whilst  rearing.  The 
symptom  is  flatness  of  the  most  rounded  part  of  the  quar- 
ter, observed  when  standing  to  one  side  of  the  patient.  An 
alteration  in  the  form  and  shape  of  the  quarters  from  any  of 
the  other  kinds  of  fracture  is  observable  when  the  practitioner 
stands  at  a  short  distance  behind  the  patient ;  but  this  is  to  be 
seen  to  perfection  when  he  stands  at  a  short  distance  on  one 
side,  and  on  a  level  with  this  part  of  the  body.  Manipulation 
will  detect  crepitus,  and  cause  pain.  In  some  cases  there  will 
be  considerable  swelling  of  the  soft  parts,  which  will  partly  hide 
the  flatness  of  the  buttock.  There  is  some  degree  of  lameness 
in  these  cases ;  but  if  rest  be  enjoined,  repair  of  the  fracture  will 
soon  take  place.  jN'o  special  surgical  treatment  will  be  needed, 
beyond  the  application  of  a  good  stiff  charge  or  plaster  after  the 
subsidence  of  the  swelling. 


FRACTURES  OF  THE  FEMUR, 

The  femur  may  be  fractured  through  its  neck  or  through  its 
shaft,  and  both  forms  are  incurable.  Fracture  through  the  neck 
commonly  occurs  along  with  fracture  through  the  acetabulum, 
and  is  to  be  detected  in  the  same  manner.  Both  in  this  form, 
and  when  occurring  through  the  shaft,  there  will  be  shortening  of 


126 


PARTICULAR  FRACTURES, 


the  limb,  the  toe  being  turned  inwards,  except  when  the  head 
of  the  femur  is  forced  into  the  foramen  ovale,  when  the  limb 
will  be  found  longer  than  its  fellow,  and  the  toe  will  be  turned 

outwards.  Fracture  of  the  femur 
sometimes  results  from  muscular 
contraction,  when  the  animal  is 
cast  and  bound  for  operation,  dis- 
placement generally  being  the 
immediate  result;  and  from  the 
numerous  muscles  which  clothe 
and  are  attached  to  this  bone,  re- 
duction of  the  fracture  is  an  im- 
possibility. I 

Fracture  of  the  Troclianters.  — 
I  have  seen  two  cases  of  fracture 
of  trochanter  minor  externus,  from 
the  patient  having  fallen  whilst 
in  the  cart,  this  part  of  the  thigh 
coming  in  contact  with  the  shafts. 
Any  one  who  has  seen  a  horse 
down,  and  half  turned  round  in 
the  shafts,  will  easily  understand 
this.  The  diagnosis  is  difficult, 
and     the     lameness     is     peculiar. 

Fig.  i2.-rracture  of  neck  of  The    elevation    of    the    foot    from 
femur,   showing  displacement  of  the    ground,    and    the    commencc- 

head ;   reunion,  with  considerable  i        r    ^i  i.       r>  j.        •  v 

formation  of  temporary  callus,     a,  ^Cnt     of    the     act     of    extension     of 

head ;  6,  trochanter  major ;  c  and  the    limb,     Seem     to     be     performed 

,  surroun  mg  eposi .  ^^^^^  ^^^^^  little  difficulty ;   but  the 

concluding  part  of  the  elevation  of  the  limb,  and  extension  of 
the  femur  on  the  pelvis,  give  the  patient  much  pain,  and  cause 
considerable  lameness.  The  foot  is  let  down  with  a  jerk;  but 
after  descending  a  short  distance,  the  pain  seems  to  abate,  and 
the  final  implanting  on  the  ground  is  performed  with  compara- 
tive ease  and  freedom.  When  the  foot  is  implanted  on  the 
ground,  another  peculiarity  may  be  observed,  namely,  that  the 
extension  of  the  pelvis  on  the  femur  is  performed  with  difficulty. 
In  order  to  see  all  these  peculiarities,  the  practitioner  must  be  a 
close  observer.  But  to  assist  the  young  practitioner,  let  him 
remember — 1st.  The  first  act  of  raising  the  foot  is  done  easily ; 


FEACTURES  OF  THE  FEMUR.  127 

2d  The  latter  part  of  this,  and  the  abduction  of  the  thigh,  cause 
pain  and  lameness  ;  Sd.  The  pain  caused  by  the  last  act  produces 
a  jerk  when  the  limb  is  suddenly  dropped,  but  when  it  has  de- 
scended a  very  short  way  the  pain  is  relieved ;  4:th.  When  the 
foot  is  on  the  ground,  and  before  the  first  act  of  elevation,  the 
trunk  is  carried  forward  in  the  act  of  progression  in  a  painful 
and  peculiar  manner.  These  peculiarities  are  explained  by  the 
fact  that  the  gluteus-externus  is  attached  to  this  trochanter,  and 
that  this  muscle  is  an  abductor  of  the  thigh  and  extensor  of  the 
pelvis. 

The  treatment  is  rest,  and  slinging,  if  the  lameness  is  great, 
or  sufficient  to  prevent  the  animal  from  lying  down  ;  with  sooth- 
ing applications  to  the  part. 

Fractures  of  the  condyles  sometimes  occur.  One  case  hap- 
pened in  the  practice  of  a  friend  of  mine  during  operation. 
The  animal  was  immediately  killed,  and  an  examination  made, 
when  it  was  found  that  the  fracture  was  of  some  duration,  and  it 
came  out  afterwards  that  the  animal  had  been  cast  in  the  stall 
some  few  weeks  previously ;  that  he  had  sliown  a  little  stiffness 
for  a  day  or  two,  but  that  this  had  passed  off.  The  bone  is  in 
my  possession. 

The  patella  is  fractured  longitudinally,  or  into  several  frag- 
ments, by  direct  violence  ;  and  transversely,  by  muscular  con- 
traction, causing  great  lameness,  more  or  less  inability  to  extend 
the  limb,  swelling  in  front  of  stifle  joint ;  these  symptoms  being 
common  to  both  kinds,  with  distinct  .separation  of  the  two  por- 
tions when  the  fracture  is  transverse.  Reunion  of  this  form 
is  an  impossibility,  owing  to  the  difficulty  of  bringing  the  frag- 
ments together,  and  from  the  presence  of  the  synovia  in  in- 
creased quantity ;  on  the  other  hand,  a  longitudinal  fracture  is 
sometimes  curable,  especially  if  it  be  a  mere  crack  in  the  bone. 
In  order  to  secure  as  much  repose  as  possible,  the  part  must  be 
thrown  into  a  state  of  relaxation,  and  for  this  purpose  a  shoe 
with  high  toe-pieces  and  heels  must  be  put  on  the  foot,  a  veri- 
table "  patten  shoe,"  the  animal  placed  in  slings,  and  cooling 
applications  employed  to  reduce  inflammation  and  swelling. 
After  a  time  a  blister  may  be  applied,  as  a  considerable  effusion 
is  apt  to  take  place  into  the  bursa,  the  absorption  of  which  is 
necessary  before  reunion  can  take  place. 


128  PARTICULAR  FRACTURES. 


FRACTURE  OF  THE  TIBIA. 

Perhaps  this  is  the  most  common  form  of  fracture  met  with 
ill  the  extremities,  arising  from  kicks,  and  occurring  most 
frequently  when  a  number  of  horses  are  turned  out  to  grass. 
The  kick  is  delivered  from  the  side  opposite  to  the  fractured 
limb,  and  descends  upon  the  internal  surface  of  the  tibia,  where 
it  is  covered  entirely  by  skin,  fascia,  and  strong  periosteum. 
'No  other  symptom  of  tliis  fracture  than  a  small  punctured 
wound  may  be  present,  the  animal  exhibiting  little  or  no  lame- 
ness, although  the  fracture  may  be  extensive.  The  fracture  is 
generally  very  oblique,  and  the  periosteum  being  strong,  the 
ends  are  not  separated.  Many  cases  are  on  record  where  horses 
have  worked  at  all  kinds  of  labour  for  days  after  the  receipt 
of  injury  without  manifesting  any  signs  of  lameness,  until  by 
a  sudden  twist  of  the  limb  separation  has  taken  place.  Another 
cause  of  displacement  is  the  animal's  lying  down ;  when  he 
attempts  to  rise,  the  broken  ends  are  forced  asunder,  perhaps 
a  sharp-pointed  extremity  of  the  broken  bone  driven  outwards 
through  the  skin,  rendering  the  case  almost  beyond  remedial 
measures.  All  cases  of  punctured  wounds  of  this  part,  from 
the  violence  of  kicks,  should  be  treated  as  if  the  bone  were 
fractured,  until  the  practitioner  is  perfectly  satisfied  upon  the 
matter.  The  patient  should  be  put  in  the  slings,  and  kept 
there  until  the  wound  is  perfectly  healed,  and  the  horse  quite 
free  from  lameness.  If  there  be  no  fracture,  but  little  thicken- 
ing will  be  left  after  the  subsidence  of  the  inflammation ;  but 
if  there  be  a  fracture,  the  veterinarian  will  be  able  to  detect 
the  presence  of  the  provisional  callus.  Non-attention  to  these 
practical  points  has  caused  the  destruction  of  many  valuable 
horses.  There  is  little  danger  of  displacement  if  the  patient 
be  kept  in  the  slings;  but  if  quite  sure  that  fractures  exist, 
the  tarred  cord  should  be  applied  round  the  leg  from  the  foot 
upwards,  as  high  up  on  the  thigh  as  possible.  Some  portion  of 
the  fragments  may  thus  be  included  in  the  cord,  for  it  must  be 
remembered  that  the  cleavage,  being  oblique,  will  extend  for 
some  distance  both  above  and  below  the  actual  wound. 

If  displacement  has  occurred  before  measures  can  be  applied, 
it  will  be  found  almost  an  impossibility,  unless  the  patient  be 
very  young,  to  perform  reduction ;  and  the  best  course  wiU  be 


FEACTURE  OF  THE  TIBIA.  129 

to  destroy  the  suffering  animal ;  but  in  the  young,  and  in  cases 
where  treatment  is  insisted  upon,  the  first  step  must  be  the 
removal  of  any  projecting  bone  by  the  bone  forceps,  and  after- 
wards traction,  applied  by  means  of  cords  to  the  hock  and  leg, 
to  produce  extension  ;  in  this  way,  and  by  proper  manipulation, 
the  fragments  may  be  approximated  and  retained  in  their 
position  by  the  means  already  described. 


FRACTURE  OF  THE  TARSAL  AND  METATARSAL  BONES. 

The  Os  Calcis. — Transverse  fracture  of  this  bone  is  caused  by 
muscular  contraction,  and  by  the  slipping  forward  of  the  limb,  thus 
throwing  the  gastroc-nemius  externus,  which  is  attached  to  the 
upper  extremity,  into  an  unduly  extended  condition,  and  the  bone 
suddenly  giving  way  in  preference  to  the  tendon  of  attachment,  or 
the  fracture  may  occur  spontaneously  when  the  bone  is  diseased. 
This  fracture  is  mostly  seen  in  young  horses,  where  the  apophysis 
is  not  completely  solidified  to  the  body  of  the  bone.  This 
accident  arises  from  the  same  causes  as  those  which  produce 
"  curb ; "  in  the  one  case,  however,  the  bone  is  the  structure  to 
give  way,  while  in  the  other  the  calcaneo-cuboid  ligament 
receives  the  injury. 

Inspection  of  the  limb  will  demonstrate  a  flatness  of  the 
point  of  the  hock,  flaccidity  of  the  tendo  acliilles,  with  an 
apparent  shortening  of  the  limb ;  there  is  no  shortening  in 
reality,  but  great  difficulty  in  bringing  the  foot  to  the  ground. 
The  lameness  is  very  considerable  ;  manipulation  will  enable  the 
practitioner  to  discover  the  detached  portion  of  bone  resting  in 
front  of  the  os  calcis,  in  close  contact  with  the  flexor  pedis 
perforans,  on  the  postero-internal  aspect  of  the  hock.  It  is 
easily  moved  by  the  hand,  and  can  be  elevated  almost  into  its 
natural  position. 

Treatment. — Apply  a  high-heeled  shoe,  then  force  the  frag- 
ment into  its  proper  position,  if  practicable,  or  as  nearly  as 
possible,  retaining  it  there  by  pads  of  tow  and  bandages.  The 
tow  must  be  made  into  firm  pads  or  rolls,  and  pressed  down  in 
front,  and  on  both  sides  of  the  fragment,  to  prevent  it  from  fall- 
ing forwards.  Over  the  dry  bandage  the  starch  bandage  must 
be  carefully  laid,  extending  from  the  foot  over  the  hock  as 
high  as  possible,  in  order  to  keep  the  limb  in  a  state  of  rigidity. 

K 


130  PARTICULAR  FRACTURES. 

The  patient  is  now  to  be  placed  in  slings ;  in  about  two  months 
consolidation  may  be  expected  ;  the  horse  may  now  be  placed 
in  a  loose  box  or  sent  to  grass.  I  have  seen  very  good  re- 
coveries from  this  accident ;  but  if  the  bone  be  in  a  diseased 
condition,  moUities  or  fragilitus  ossium  treatment  will  be  of  no 
avail. 

The  tarsal  bones  are  all  liable  to  be  fractured  by  direct 
violence  (see  Photo-lithograph,  Plate  II.,  Fig.  6 — Fracture  of 
the  Astragalus),  and,  if  associated  with  a  wound,  it  is  necessary 
to  destroy  the  animal ;  but  cases  of  very  severe  injuries  without 
wound  occur,  where  the  patients  completely  recover;  but  ex- 
amination after  the  death  of  the  animal,  perhaps  years  after- 
wards, reveals  the  fact  that  the  bones  had  been  broken.  It 
will  be  understood  by  the  anatomist  that  this  applies  to  the 
cuneiform  and  cuboid  bones  only ;  for  where  the  astragalus  has 
been  involved,  only  one  method  of  repair  can  take  place,  and 
that  is  anchylosis  of  the  true  hock-joint.  It  is  most  difficult  to 
diagnose  this  form  of  injury  correctly,  from  the  great  tendency 
to  immediate  swelling  of  the  part,  and  from  the  absence  of 
crepitation ;  the  reason  being  that  the  bones  are  firmly  bound 
to  each  other,  and  to  the  metatarsals,  by  very  numerous  liga- 
ments. 

If  the  patient  be  worth  treatment,  it  will  be  advisable  to 
apply  the  high-heeled  shoe,  to  place  him  in  the  slings,  and  to 
abate  irritation  and  fever  by  fomentations  lightly  applied,  by 
sedatives,  or  even  anodynes,  as  aconite  and  opium,  regulating 
the  action  of  the  bowels  by  laxative  food  and  gentle  aperients. 
After  the  subsidence  of  the  fever  and  of  the  local  heat,  when 
two  or  three  weeks  have  elapsed,  a  blister  will  be  of  great  service 
in  removing  pain,  and  in  hastening  the  process  of  ossification. 
Fractures  occurring  below  the  hock,  except  from  kicks  or  blows, 
are  extremely  rare ;  they  may  result  from  concussion,  or  the 
sudden  twisting  of  the  limb  ;  but  they  are  much  more  commonly 
found  to  occur  from  these  causes  in  the  anterior  extremities. 
I  shall  therefore  consider  them  along  with  those  of  the  fore 
limbs. 


CHAPTEE  VIL 

PARTICULAR   FRACTURES — COntiuiLed. 

FRACTURES  OF  SCAPULA — HUMERUS — CONDYLES — OLECRANON — RADIUS 

ULNA TRAPEZIUM,  CARPAL,  METACARPAL,  AND  SESAMOID  BONES 

"  SPLIT    PASTERNS  " NAVICULAR  AND  PEDAL  BONES BROKEN 

RIBS — LUXATIONS — CASE    OF    DISLOCATION    OF   THIRD     CERVICAL 
VERTEBRA. 

The  College  Museum  contains  many  cases  of  recovered  fractured 
scapulae ;  and  this  bone  is  liable  to  be  broken  through  its  neck 
or  body  by  muscular  contraction,  and  through  its  spine  by  direct 
violence,  caused  by  blows  or  falls, 

Compound  fracture  of  the  spine  will  sometimes  be  found  to 
exist  with  the  fragments  completely  detached ;  in  such  a  case, 
they  must  be  removed. 

When  the  body  or  neck  is  the  seat  of  the  lesion,  if  there  is  not 
much  displacement,  speedy  reunion  will  take  place,  and  the  ani- 
mal completely  recover,  provided  the  articulation  be  not  involved. 

But  little  can  be  done  in  these  cases  beyond  enjoining  quietude, 
placing  the  animals  in  slings,  and  watching  for  untoward  com- 
plications. 

When  the  humerus  is  broken,  I  am  of  opinion  that  recovery  is 
impossible,  although  Professor  Dick  taught  that  such  might  take 
place.  The  practitioner  well  knows  that  many  powerful  muscles 
are  attached  to  this  bone,  the  action  of  which  will  render  the  re- 
tention of  the  broken  bone  in  anything  like  its  proper  position 
an  impossibility.  Fractures  of  the  tubercles,  of  course,  like  those 
of  the  trochanters  of  the  femur,  will  be  an  exception  to  this  rule. 

When  the  humerus  is  broken,  there  is  an  immediate  shortening 
of  the  limb,  from  the  inferior  portion  of  the  bone  being  drawn 
upwards  by  the  muscles  attached  to  it;  great  lameness;  and 
there  is  very  often  a  rupture  of  the  humeral  artery,  or  of  one  of  ita 


132  PARTICULAR  FRACTURES. 

large  branches,  with  subcutaneous  haemorrhage,  causing  great 
engorgement  of  this  part  of  the  limb,  and  rendering  the  detec- 
tion of  crepitus  an  impossibility.  But  the  practitioner  need  not 
hesitate  in  arriving  at  a  correct  diagnosis,  as  the  pendulous  leg, 
inability  to  place  any  weight  upon  it,  and  the  sudden  engorge- 
ment are  quite  sufficient  to  prove  the  existence  of  the  fracture. 

This  fracture  may  arise  from  muscular  action ;  but  commonly 
it  is  caused  by  falls.  One  case,  however,  has  come  under  my 
notice,  where  it  aro3e  from  fragility  of  a  portion  of  the  shaft  of 
the  bone,  from  its  being  continually  brought  into  contact  witli 
the  carriage  pole. 

The  animal  was  a  very  fine  carriage  horse,  one  of  a  pair,  with 
splendid  and  fast  action.  Shortly  before  the  final  catastrophe 
he  showed  signs  of  a  slight  lameness,  attributable  to  the  shoulder ; 
with  short  rest  and  treatment  he  recovered,  and  was  put  to  work, 
at  which  he  continued  for  some  little  time.  Wliilst  out  one  day, 
and  upon  a  very  level  road,  that  between  Bingley  and  Keighley, 
in  Yorkshire,  and  going  at  a  good  pace,  he  suddenly  fell — the 
leg  completely  giving  way — bringing  the  other  horse,  carriage 
and  all,  to  the  ground.  He  could  not  rise,  the  humerus  was 
fractured,  and,  upon  examination,  it  was  found  to  be  in  a  state 
of  degenerative  disease  just  at  the  part  which  was  on  a  level 
with  the  carriage  pole. 

The  condyles  of  the  humerus  are  occasionally  fractured,  and, 
as  a  rule,  they  never  reunite,  the  reason  being  the  impossibility  of 
keeping  the  limb  in  a  state  of  complete  rest. 

The  radius  and  ulna  are  fractured  by  direct  violence,  and  the 
olecranon  by  muscular  contraction.  In  dogs  this  fracture  is  not 
at  all  uncommon ;  and,  if  properly  fixed  with  bandages,  generally 
recover  without  leaving  much  lameness.  I  have  noticed  one 
case  of  dislocation  of  the  elbow-joint,  accompanied  by  rupture  of 
the  internal  lateral  ligament ;  although  treated  for  some  time,  it 
did  no  good,  and  was  ultimately  destroyed.  The  dislocation  was 
easily  reduced,  and  bound  up  very  firmly ;  but  owing  to  diseased 
action  having  taken  place  in  the  joint,  it  was  seen  that  anchylosis 
would  be  the  result.  In  the  case  of  a  brood  mare,  or  valuable 
stallion,  cases  of  this  kind  might  very  justly  be  treated ;  but  in 
horses  required  for  work  it  will  be  better  to  order  the  patient  to 
be  put  out  of  pain,  as  a  horse  with  a  stiff  elbow  is  of  little  use. 
A  dislocation  is  easily  distinguished  from  fracture,  as  in  the  one 


FKACTURES  OF  THE  SCAPULA,  ETC.  133 

case  you  have  displacement  and  contortion  without  crepitus, 
whereas  the  sound  is  present  in  the  other.  There  never  need  be 
any  difficulty  in  diagnosing  fracture  when  displacement  has 
resulted ;  the  difficulty  is  in  forming  a  correct  opinion  when  this 
has  not  taken  place. 

The  olecranon  is  fractured  transversely  by  over-extension ;  it 
snaps  across  about  its  middle.  It  will  be  remembered  that  the 
very  powerful  triceps  and  scapulo-ulnaris  muscles  are  attached 
to  the  olecranon.  When  the  animal  slips  forward  to  any  great 
extent,  these  muscles  are  thrown  into  a  state  of  great  tension ; 
in  fact,  they  are  extended  beyond  their  limit.  The  results  from 
this  are,  laceration  of  their  tendons  of  insertion,  fracture  of  the 
bone  into  which  they  are  inserted,  rupture  of  the  muscles  them- 
selves, or  all  these  lesions  combined.  Any  of  these  cause 
immediate  and  great  lameness ;  the  animal  will  stand  with  the 
whole  limb  in  an  exceedingly  relaxed  and  semi-flexed  condition, 
with  almost  total  inability  to  move  it,  and  to  support  any  weight 
uj'on  it.  The  detached  bone  being  drawn  upwards  into  the 
deep  bed  of  muscular  tissue  posterior  to  the  humerus,  and  the 
parts,  as  a  rule,  immediately  swelling,  crepitation  cannot  be 
detected,  and  it  becomes  a  matter  of  great  difficulty  to  form  a 
correct  diagnosis.  Mr.  Anderson,  V.S.,  Glasgow,  has  discovered 
an  almost  unfaihng  way,  and  it  is  as  follows : — Let  the  practi- 
tioner place  his  knee  firmly  against  the  knee  of  the  patient's 
injured  leg,  and  by  firm  pressure  he  is  to  straighten  the  semi- 
flexed limb,  and  to  keep  it  in  that  position,  while  an  assistant 
is  directed  to  lift  up  the  horse's  opposite  fore  foot.  If  the  ole- 
cranon is  fractured,  the  patient  is  unable  to  stand;  but  if  there 
be  merely  laceration,  he  will  be  able  to  bear  his  weight,  with  the 
assistance  at  the  knee  given  by  the  practitioner. 

There  are  two  positions  in  which  the  limb  is  maintained  when 
suffering  from  this  injury,  namely,  semi-flexed  with  the  foot  in 
advance,  with  the  heel  touching  the  ground;  or  semi-flexed 
with  the  foot  behind,  knuclding  over,  the  toe  only  touching  the 
ground,  and  turned  inwards. 

Correct  diagnosis  is  of  the  greatest  importance  in  cases  of  this 
kind,  as  in  laceration  of  the  tendons,  or  of  the  muscular  struc- 
ture, a  recovery  may  be  expected ;  whereas,  if  the  bone  is  broken, 
little  good  can  be  done  if  the  fracture  is  complete,  and  the 
fragments  are  separated  by  muscular  action. 


134  .  PARTICULAR  FRACTURES. 

In  this  fracture  it  will  be  found  that  union  is  by  false  joint. 
This  will  interfere  more  or  less  with  the  action  of  the  animal 
ever  afterwards ;  but  by  far  the  most  common  result  is  intense 
inflammation,  set  up  by  the  irritation  of  the  broken  fragments, 
which  become  necrosed,  abscesses  form,  commonly  communi- 
cating with  the  elbow-joint,  and  the  animal  dying  (or  having  to 
be  destroyed)  from  irritative  fever. 

Eeasoning  from  these  facts,  I  am  of  opinion  that  the  most 
rational  method  of  treatment  will  be  at  once  to  cut  down  upon 
and  remove  the  fragment  or  fragments  w^hich  may  be  separated 
from  the  bone,  bringing  the  lips  of  the  wound  together  by  suture, 
applying  the  slings,  and  other  appropriate  remedies. 

There  is  a  peculiarity  about  injuries  to  the  neighbourhood  of 
the  elbow  which  leads  to  the  burrowing  of  any  pus  that  may 
form  into  the  articulation,  and  in  this  way  cause  a  most  dis- 
tressing complication — that  of  open  joint.  Kicks  or  punctures, 
although  they  may  be  inflicted  upon  a  part  of  the  fore  arm,  at 
a  distance  of  four  inches  from  the  joint,  will  often  produce  this 
dreaded  complication,  if  great  care  is  not  taken  in  giving  free 
vent  to  all  collections  of  matter ;  and  the  reason  for  it  is  to  be 
found  in  the  peculiarly  firm  nature  of  the  muscular  and  other 
structures  of  this  part,  the  muscles  being  individually  clothed 
in  firm  thecae,  and  the  whole  enveloped  in  the  brachial  fascia. 

Treatment. — Eest  in  the  slings,  and  the  maintenance  of  the 
limb  in  the  position  most  calculated  to  favour  the  process  of 
repair  by  a  properly  adjusted  shoe — high-heeled  or  otherwise — 
or  by  the  removal  of  the  shoe,  as  each  individual  case  presents 
its  own  peculiarity  of  symptoms.  These  details  of  practice  must 
be  left  to  the  judgment  of  the  practitioner,  who  alone  will  be 
able  to  carry  out  what  may  strike  him  as  essential  to  the  well- 
being  of  his  patient. 

Fracture  by  direct  violence  is  that  most  commonly  met  with, 
and,  in  the  majority  of  instances,  from  falls  in  the  cart;  the 
elbow  being  thrown  across  the  shaft,  and  both  radius  and  ulna 
broken  through  into  the  articulation. 

This  lesion  is  easily  diagnosed  by  distortion  and  crepitus. 
Ko  treatment  can  be  recommended. 

If  the  ulna  only  is  broken,  it  will  be  found  that  the  fracture  is 
through  "the  beak  of  the  olecranon,"  involving  the  surface,  which 
articulates  with  the  humerus  between  and  behind  the  condyles. 


SPLIT  PASTERNS.  135 

No  treatment,  as  the  whole  joint  is  sure  to  become  involved 
in  the  inflammatory  actiun. 

The  radius  is  broken  at  its  upper  third,  the  ulna  sometimes 
being  involved ;  if  it  be  transverse,  or  not  sufficiently  oblique 
to  involve  the  elbow-joint,  it  is,  as  a  rule,  amenable  to  treat- 
ment. I  have  seen  many  cases  do  very  well.  It  is  much 
easier  to  treat  than  when  the  ulna  only  has  given  way,  for  in 
the  latter  instance  it  is  very  difficult  to  bring  the  displaced 
fragments  into  proper  position,  as  the  muscles  act  upon  it,  and 
draw  the  fragments  apart. 

But  when  both  radius  and  ulna  have  given  way,  the  displace- 
ment is  less,  and  we  have  greater  command  over  the  limb  than 
over  the  ulna,  which  is  fixed*  to  the  radius  by  interosseous  liga- 
mentous tissue.  In  the  treatment  of  fractured  radius,  or  of 
both  bones  combined,  the  reduction  must  be  effected  by  ex- 
tension and  counter-extension,  and  the  fragments  kept  in 
apposition  by  bandages,  tar-cord,  and  by  the  long  splint. 

The  radius  is  broken  at  its  lower  third  from  direct  violence, 
as  kicks  and  blows ;  the  nearer  it  is  to  the  knee,  the  greater  the 
difficulty  in  managing  the  treatment. 

Fractures  of  the  bones  of  the  knee  arise  from  direct  violence, 
as  kicks  and  falls.  As  a  rule,  there  is  no  treatment.  The 
upper  and  middle  row  of  carpal  bones  are  most  commonly  the 
bones  broken.  If  from  a  fall,  the  tendon  of  the  extensor 
metacarpi  magnus  is  lacerated  and  torn,  and  the  wound  will 
be  upon  the  front  of  the  knee. 

One  case  of  fracture  of  the  trapezium  has  been  mentioned  to 
me  by  Mr.  Anderson,  Glasgow.  The  case  was  treated  for  a  long 
time,  but,  I  believe,  with  no  good  result. 

The  metacarpal  bones,  as  well  as  the  suffragines,  more  espe- 
cially the  last-named  bones,  are^  broken  into  many  fragments, 
sometimes  into  scores  of  pieces,  most  mysteriously,  while  the 
animal  is  galloped  upon  sandy  or  soft  ground.  The  sandy  beach 
of  Portobello  is  noted  for  this. 

Transverse  fractures  of  the  sesamoids  sometimes  occur  spon- 
taneously when  the  bones  are  in  a  fragile  condition  from  organic 
disease,  and  are  incurable.  The  symptoms  are  descent  of  the 
fetlock  pad,  elevation  of  the  toe,  with  great  lameness,  and  the 
presence  of  a  depression,  marking  the  seat  of  the  fracture  in 
the  bone  or  bones. 


13G 


PARTICULAR  FRACTURES. 


Simple  fractures  of  the  pastern  bones,  even  when  the  joint  is 
involved,  make  good  recoveries  when  properly  treated  by  band- 
ages, splints,  and  rest  in  the  slings. 

Split  pastern  is  of  common  occurrence. 

The  diagnostic  signs  of  this  are  very  sudden  and  severe  lame- 
ness, occurring  when  the  animal  is  upon  a  hard  road  ;  the  lesion 
arising  from  concussion. 

Sometimes  crepitus  can  be  detected,  but  very  often  this  is 
absent,  from  the  fact  that  the  bone  is  bound  most  securely  by  un- 
yielding ligaments.  The  suffragines  are  most  commonly  broken, 
but  it  is  not  a  rare  thing  to  find  the  coronse  fractured  also. 


Fig.  13. — Perpendicular  split 
through  the  central  groove  on  the 
upper  extremity  of  os  sufiraginis. 


Fig.     14. — Irregular   fracture    of 
upper  extremity  of  os  sufiraginis. 


When  one  bone  only  is  broken,  recovery  is  the  rule,  although 
the  articulation  may  be  involved. 

In  the  course  of  a  day  or  two  after  the  accident,  the  pastern 
will  swell,  and  the  swelling  is  of  a  hard,  unyielding  character. 
This  is  a  favourable  sign,  as  it  indicates  the  formation  of  plastic 
lymph  in  the  part,  and  the  commencement  of  the  process  of  repair. 

There  is  no  necessity  for  very  firm  bandaging,  especially  if 
crepitus  be  absent.  The  shoe  should  be  carefully  removed,  and 
the  horse  allowed  to  stand  with  the  lame  foot  upon  sawdust,  or 
some  material  which  will  adapt  itself  to  the  form  and  peculiari- 
ties of  the  position  of  the  foot.  The  toe  of  the  foot  will  only 
touch  the  level  ground,  and  it  will  be  a  great  relief  to  the  horse 
if  the  material  he  stands  upon  will  allow  the  heel  also  to  be 
supported.  In  about  two  or  three  months,  depending  upon  the 
progress  of  the  case,  if  the  injury  be  to  a  fore  extremity,  the 
slings  may  be  removed  ;  but  if  it  be  a  hind  leg,  the  slings  must 
be  made  use  of  for  a  longer  period. 


FEACTUEE  OF  THE  SESAMOID  BONES.  137 

I  have  seen  one  case  of  transverse  fracture  of  the  sesamoid 
bones,  both  bones  being  involved.  The  diagnosis  was  difificidt, 
as  there  was  much  swelling  around  the  fetlock ;  the  toe  was 
elevated ;  the  fetlock  pad  came  to  the  ground ;  and  there  was 
very  great  lameness  ;  and  the  symptoms  were  exactly  like  those 
of  rupture  of  the  superior  suspensory  ligament.  The  horse,  being 
an  old  one,  was  destroyed.  I  do  not  see  that  there  can  be  a 
possibility  of  rendering  an  animal  ser^^.ceable  after  an  accident 
of  this  kind.  In  the  first  place,  it  would  be  almost  impossible 
to  keep  the  fragments  in  contact,  owing  to  the  tendency  of  the 
fetlock  to  fall  downwards  and  the  toe  to  be  drawn  upwards  by 
the  extensor  pedis ;  and,  secondly,  the  sesamoids,  articulating 
by  one  surface  with  the  metacarpal,  the  fetlock  joint  would 
become  anchylosed,  and  by  the  other  surface  forming  a  synovial 
bursa,  over  which  the  perforans  glides,  the  tendon  would  be- 
come diseased  to  a  considerable  extent,  constituting  a  permanent 
lameness. 

Fracture  of  the  navicular  bone  occurs  in  two  ways  ;  first,  by 
direct  puncture,  as  when  a  nail  penetrates  the  frog.  These  cases 
are  rare,  but  they  do  happen ;  the  symptoms  are  excessive  lame- 
ness, presence  of  the  foreign  body,  or  of  the  wound  from  which 
it  has  been  removed,  synovial  discharge,  abundant,  often  bloody, 
and  after  a  time  mixed  with  flaky  pus ;  abscesses  commonly 
form  around  the  coronet ;  the  animal  suffers  from  a  high  degree 
of  irritative  fever,  and  if  not  put  out  of  his  suffering,  dies  from 
pain  and  exhaustion.  It  is  of  the  greatest  importance  to  know 
if  the  bone  be  broken  or  not,  as  many  cases  of  open  navicular 
joint  recover  when  uncomplicated  with  fracture. 

In  open  joint  without  fracture,  the  pain  and  fever  may  be  as 
great  at  first  as  when  fracture  is  present,  but  the  discharge  from 
the  wound  will  be  synovial,  straw-eoloured,  or  mixed  with  a  small 
quantity  of  odourless  pus ;  whereas,  if  the  bone  be  broken,  there 
will  be  more  or  less  continual  oozing  of  blood  from  its  cancel- 
lated tissue,  tinging  the  discharge  with  a  dirty-red  hue,  and 
giving  it  a  foetid  odour.  When  these  symptoms  are  present,  say 
in  two  days  after  the  injury,  the  animal  had  better  be  destroyed. 
It  is  as  well  to  wait,  say  for  two  days,  as  the  colour  may  be  due 
to  the  oozing  of  blood  from  the  soft  structures,  and  not  from  the 
bone. 

The  other  way  in  which  the  navicular  bone  is  fractured,  is 


138 


PARTICULAR  FRACTURES. 


when  it  has  been  nearly  worn  through  by  the  caries  of  chronic 
navicular  disease.  Very  often  this  fracture  is  accompanied  by 
rupture  of  the  diseased  portion  of  the  tendo  perforans,  and  in 
such  a  case  the  toe  is  immediately  turned  up,  making  the  diag- 
nosis certain ;  when  this  complication  is  not  present,  it  is  more 
difficult  to  arrive  at  a  sure  conclusion,  and  the  history  of  the 
case  must  be  taken  into  account.  The  horse  has  been  lame,  but 
serviceable,  for  a  long  time,  and  all  at  once  he  becomes  help- 
lessly lame  and  unfit  for  further  use.  The  practitioner  must 
draw  his  own  conclusions,  and  reason  upon  the  case,  as  no  set 
rule  can  be  laid  down. 

This  form  of  fracture  occurs  very  often  after  the  operation  of 
neurotomy,  from  the  increased  freedom  of  motion  which  results 
upon  the  removal  of  pain ;  both  tendon  and  bone  giving  way, 
the  fetlock  coming  to  the  ground,  &c.  I  have  seen  one  case  that 
goes  to  prove  that  mere  fracture  of  the  bone  after  this  operation 
does  not  always  cause  inconvenience  to  the  animal;  and  sub- 
joined are  two  woodcuts,  of  the  navicular   bone  from    a  horse 


Figs,  15  and  16  show  both  surfaces  of  the  Navicular  bone, 
described  in  the  text. 

unnerved  by  me  at  the  Veterinary  College  more  than  three  years 
before  he  was  destroyed.  During  the  whole  of  that  time  he 
performed  his  worlv  well  and  soundly,  and  ultimately  had  to  be 
put  away,  owing  to  the  occurrence  of  necrosis  of  the  os  j^edis. 


FRACTURE  OF  THE  NAVICULAR  BONE.  139 

Upon  exanjination,  the  navicular  bone  was  found  fractured, 
and  the  fracture  reunited  by  false  joint.  I  am  of  opinion  that 
the  fracture  had  occurred  immediately  after  the  operation,  and 
that  union  had  taken  place  very  shortly  afterwards.  The  case 
was  under  very  favourable  circumstances,  being  driven  in  the 
cart  by  a  very  careful  old  man,  and  never  pushed  beyond  a 
walking  pace. 

The  OS  pedis  is  fractured  in  various  ways : — 1st.  By  violence, 
as  when  the  calkins  of  the  shoe  are  entangled  in  a  railway  point, 
the  horse  falling,  and  a  large  portion  of  the  crust  becoming  de- 
tached, and  at  the  same  time  the  bone  being  lacerated.  2d. 
From  the  falling  of  heavy  weights  upon  the  feet.  od.  By  con- 
cussion ;  but  before  this  form  of  fracture  can  occur  the  bone  must 
be  in  a  fragile  condition,  resulting  from  chronic  laminitis.  Ath. 
From  the  prick  of  a  nail  in  shoeing.  This  fracture  may  be 
immediate,  or  a  piece  of  bone  may  become  detached  from  the 
pressure  of  the  nail,  thus  constituting  a  fracture  by  partial 
necrosis. 

The  first  kind  may  be  considered  beyond  treatment,  unless, 
indeed,  the  fracture  be  very  slight,  and  easily  removed.  The 
proper  treatment  will  be  the  removal  of  all  detached  horn  and 
fragments  of  bone,  the  application  of  poultices,  and  the  ad- 
ministration of  febrifuges,  with  rest  in  the  slings  until  the  fever 
subsides. 

It  is  curious  to  observe  how  soon  a  portion  of  foot  stripped  of 
its  crust  is  sheathed  and  coated  over  by  the  horny  secretion  of 
the  sensitive  laminae ;  in  a  very  few  days,  if  the  laceration  of 
the  soft  tissues  has  not  been  great — where  the  horn  is  merely 
stripped  off — it  will  be  found  that  the  soft  structures  are  covered 
over  by  a  layer  of  protecting  horn,  which  prevents  further  irri- 
tation, and  enables  the  patient  to  niove  the  foot  with  comparative 
ease.      Had  the  advocates  of  the  hypothesis,  that  the  horny 
laminse  are  secreted  by  the  coronary  substance,  only  remembered 
what  they  must  have  observed  in  the  course  of  their  practice, 
they  never  would  have  propounded  such  an  absurdity.^     After 
the  pain  and  fever  have  subsided,  the  practitioner  must  deter- 
mine if  a  shoe  can  be  applied  with  advantage  or  not.     If  it  be 

^  Notwithstanding  the  severe  strictures  of  one  critic,  who  states  that  the  laminae 
do  not  secrete  horn,  I  maintain  my  view  that  a  horny  secretion  is  formed  by  them 
independently  of  the  coronary  band. 


140  PAKTICULAR  FRACTURES. 

thought  necessary,  it  must  be  a  bar-shoe,  made  as  light  as  pos- 
sible, and  nailed  to  the  uninjured  part ;  the  foot  is  then  to  be 
enveloped  in  a  soft  dressing,  consisting  of  fine  tow,  tar,  and  band- 
ages. But  if  the  bone  be  broken  into  several  fragments,  or  when 
it  is  cleft  through  its  centre,  and  into  the  pedal  articulation,  it 
will  be  advisable  to  destroy  the  patient. 

The  second  and  third  forms  are,  as  a  rule,  incurable.  The  last 
form  is  partial,  but  is  always  to  be  considered  of  great  impor- 
tance, although  by  careful  and  timely  treatment  the  results  may 
be  satisfactory.  The  symptoms  are  those  of  pricked  foot,  with 
or  without  suppuration.  At  first  it  is  impossible  to  say  whether 
there  is  a  fragment  or  not.  But  let  the  practitioner  observe 
that,  when  the  foot  is  pricked,  the  removal  of  the  offending  body, 
the  paring  out  of  the  foot,  and  giving  exit  to  the  imprisoned  pus, 
will,  as  a  rule,  give  relief.  But  if  a  portion  of  the  bone  be  de- 
tached, the  animal  will  continue  as  lame  as  he  was  prior  to  the 
treatment ;  or  it  will  be  found  that  the  pain  and  fever  increase 
from  hour  to  hour,  abscesses  form  around  the  coronet,  and  the 
animal  will  die  in  great  agony  in  the  course  of  a  very  short  time. 

The  treatment  must  be  prompt.  If  it  be  found  that  relief 
does  not  follow  the  treatment  appropriate  for  punctured  foot, 
the  practitioner  must  cut  down  on  the  pedal  bone  at  the  seat 
of  the  pain  or  suppuration,  and  explore.  He  will  find  a  loose 
fragment ;  this  he  must  remove  as  speedily  as  he  can.  It  may 
be  no  larger  than  a  small  pea,  or  it  may  be  the  size  of  a  bean, 
but  out  it  must  come.  When  this  is  effected,  relief  is  generally 
obtained;  the  after  treatment  being  poultices,  cathartics,  ano- 
dynes, and  febrifuges. 


BROKEN  RIBS. 

The  attention  of  the  veterinarian  is  but  seldom  called  to  this 
injury,  yet  ])ost  mortem  examinations  reveal  in  many  instances 
that  the  ribs  have  been  fractured  at  some  time  or  other  of  the 
animal's  existence ;  the  method  of  repair  being  always  by  the 
en  sheathing  callus.  In  none  of  these  cases  has  there  been  any 
record  of  the  accident,  nor  indeed  would  there  be  any  symptoms 
present  to  indicate  such,  if  the  fracture  had  not  been  a  compound 
one. 

The  causes  are  direct  violence,  such  as  kicks  from  other  horses, 
and  blows. 


BROKEN  EIBS.  141 

In  compound  fracture — the  only  kind  that  the  veterinarian 
will  be  most  likely  called  upon  to  attend,  as  in  simple  fracture 
it  is  rarely  necessary  to  do  anything — it  may  be  found  that  the 
lung  is  wounded,  and  that  the  patient  will  be  suffering  from 
pneumonia.  It  might  be  supposed  that  collapse  of  the  lungs 
would  immediately  occur  upon  the  admission  of  air  into  the 
cavity  of  the  thorax ;  but  this  does  not  take  place  to  such  an 
extent  as  one  might  imagine.  The  air  will  be  found  to  rush  in 
and  out  of  the  thorax  through  the  wound  at  each  respiratory 
movement ;  that  is,  it  will  rush  in  during  expiration,  and  out 
during  inspiration. 

Treatment. — To  find  out  if  the  lung  is  punctured,  and  if 
the  fragment  or  fragments  of  the  bone  are  displaced,  and  to 
replace  them  in  their  proper  position.  All  this  may  be  done 
by  introducing  the  finger  into  the  wound,  and  by  converting 
the  compound  into  simple  fracture ;  closing  the  external  open- 
ing by  a  good  stiff  plaster— the  Burgundy  or  the  common  pitch 
will  do  very  well — to  limit  the  movements  of  the  chest  by 
a  broad  belt,  and  to  watch  carefully  for  signs  of  pleurisy  and 
pneumonia. 

If  called  upon  immediately  after  the  accident,  purgatives 
may  be  prescribed  with  advantage ;  but  should  the  case  have 
been  neglected  until  inflammation  of  the  pulmonary  organs 
begins  to  manifest  itself,  purgatives  must  be  withheld,  and 
sedatives,  as  aconite,  with  the  nitrate  of  potash,  administered. 

The  ribs  may  be  fractured,  and  the  skin  not  broken,  but 
when  the  subcutaneous  tissues  are  bruised  to  a  considerable 
extent,  it  will  be  almost  impossible  to  diagnose  the  fracture.  It 
may  only  be  supposed  to  exist  by  the  severity  of  the  injury, 
and  by  the  animal  perhaps  manifesting  symptoms  of  pleurisy. 
It  is  a  remarkable  fact  that  broken  ribs,  when  broken  inwards, 
although  it  must  be  at  the  risk  of  wounding  the  lungs,  are 
more  readily  repaired  than  when  an  opening  is  made  externally; 
this  is  due  to  the  spores,  or  organic  particles  contained  in  the 
atmosphere — being  the  germs  of  low  forms  of  life  discovered  by 
the  microscope,  causing  putrescence  and  suppuration.  This  fact 
will  point  out  the  importance  of  closing  the  wound  of  compound 
fracture,  and  also  of  arresting  suppuration,  if  it  has  already 
commenced,  by  carbolic  acid  dressings. 


142  PAETICULAR  FKACTURES. 


LUXATIONS,  OR  DISLOCATIONS  WITHOUT  FRACTURE, 

Are  very  rare  in  our  patients ;  the  most  common  forms  are  those 
of  the  patella  of  the  horse,  the  head  of  femur  and  carpus  of  the 
dog,  and  that  partial  form  which  may  be  said  to  exist  in  what 
is  termed  "  knuckling  over  "  at  the  fetlock  in  the  horse.  It  is 
said  by  some  that  the  shoulder-joint  is  dislocated  without  frac- 
ture in  the  horse,  and  I  am  inclined  to  think  that  such  a  thing 
may  occur,  but  it  can  only  be  very  rarely  met  with ;  the  ana- 
tomy of  the  articulation,  the  broad  and  extensive  head  of  the 
humerus,  allowing  the  comparatively  small  glenoid  cavity  of 
the  scapula  a  freedom  and  extent  of  motion  which  renders  dis- 
location almost  an  impossibility.  The  following  case,  I  think, 
proves  that  the  injury  can  take  place.  A  horse  slipped  and 
fell ;  when  he  rose,  one  fore  leg  was  found  powerless,  pendulous, 
shorter  than  its  fellow,  and  bulging  outwards  at  the  shoulder- 
joint.  He  was  taken  to  a  stable,  where  he  immediately  lay 
down,  groaned  in  agony,  was  very  restless,  and  unable  to  rise 
to  his  feet.  A  practitioner,  who  was  sent  for,  pronounced  the 
shoulder  to  be  out;  he  secured  the  animal's  other  legs  by 
means  of  hobbles,  applied  ropes  to  the  lame  limb  above  the 
knee  and  at  the  pastern,  and  had  several  men  to  pull  steadily 
at  the  ropes  to  cause  extension.  When  all  was  ready,  he  slipped 
his  boots  off,  and  suddenly  jumped  with  force  on  the  damaged 
joint,  which  immediately  gave  a  kind  of  crack,  and  the  bulging 
suddenly  disappeared.  The  ropes  and  hobbles  were  now  re- 
moved, the  horse  assisted  to  his  feet,  when  he  was  found  to  be 
nearly  well,  and  walked  home,  a  distance  of  about  three  miles, 
that  night.  I  was  a  boy  at  the  time,  but  I  remember  the  whole 
thing  very  vividly.  The  late  Mr.  Barlow  was  of  opinion  that 
this  dislocation  was  an  impossibility;  but  when  I  mentioned 
the  above  case  to  him,  he  was  much  struck,  and  confessed  that 
it  was  sufficient  to  stagger  him. 

Luxation  of  the  Patella  occurs  in  young  horses  that  are  grazed 
on  very  hilly  pastures,  from  the  mal- position  in  which  the  limbs 
have  to  be  constantly  kept,  owing  to  the  inequality  of  the 
ground.  The  patella  is  forced  outwards;  the  internal  lateral 
ligament  becomes  stretched  across  the  internal  prominence  of 
the  trochlea  of  the  femur^  and  is  thus  torn  or  chafed.  At  first, 
the  luxation  is  only  partial,  tlie  patella  slips  in  and  out  of  its 


LUXATIONS. 


143 


position  with  a  clucking  noise  at  every  step  the  animal  takes ; 
very  commonly  both  patellae  are  in  the  same  condition.  When 
the  luxation  is  complete, 
the  internal  lateral  liga- 
ment must  be  ruptured 
throuGjh  its  whole  thick- 
ness,  and  the  patella 
shps  outwards.  The  limb 
now  becomes  stretched 
backwards ;  there  is  total 
inability  on  the  part  of 
the  animal  to  flex  it, 
owing  to  the  action  of 
the  vasti,  rectus  femoris, 
crureus,  &c.,  being  inter- 
fered with. 

Treatjnent. — Forcible 
extension    and  keepinoj     ^     ,«     ^    n       r  ^-u    r  ^     •,^4-t.<. 

^     ^       Fig.  17. — Trochlea  of  the  femur,  showing  the 

the  limb  m  a  forward  effects  of  friction  from  luxation  of  patella,  a,  Ex- 
position by  means  of  a  ternal,  and  6,  internal  trochlea,  d  and  c,  Condyles 
■'■  "^  of  the  femur, 

strong   cord   round  the 

foot.  The  leg  must  be  kept  in  this  position  by  the  cord  being 
fastened  round  the  neck  of^  the  animal  for  some  hours ;  a  shoe 
higher  at  the  toe  than  at  the  heels  should  be  put  on,  with  a 
projecting  piece  of  iron  at  the  toe,  and  a  smart  blister  applied 
to  the  stifle.  Professor  Dick  used  to  say  that  this  would  per- 
form a  cure,  even  after  the  ligament  had  entirely  given  way, 
provided  the  animal  were  kept  at  rest. 

If  the  dislocation  has  been  existent  for  any  time,  the  articular 
cartilage  on  the  surfaces  of  the  trochlea  and  patella  becomes 
worn  by  attrition ;  the  articular  laminal  layer  of  bone  is  then 
rubbed  off,  the  cancellated  tissue  exposed,  and  there  is  a  deposi- 
tion of  porcellaneous  material  (porcellaneous  deposit)  in  the 
opened-up  Haversian  canals,  giving  the  articulating  surfaces  a 
shining  or  glistening  appearance.  A  restoration  of  the  animal  to 
usefulness  will  be  now  a  matter  beyond  possibility ;  indeed  it  is 
hardly  conceivable  that  a  complete  dislocation  with  rupture  of 
the  ligament  can  at  any  time  be  curable. 


144  PAllTICULAR  FKACTUKES. 

Partial  disolocation  of  the  Fetlock  Joints,  arising  from  diseases 
of  the  feet,  over-work,  or  a  natural  tendency  to  "  knuckle  over," 
is  an  occurrence  of  which  little  need  be  said,  and  with  the 
exception  of  rest  and  perhaps  a  blister,  no  treatment  can  be 
recommended.^ 

This  form  of  unsoundness  may  also  arise  from  relaxation  of 
the  binding  ligaments,  and  this  may  be  the  result  of  chronic 
inflammation  of  them,  leading  to  a  degeneration  of  their  proper 
structure,  when  they  will  be  found  pulpy,  more  or  less  thick- 
ened, and  the  areolar  tissue  which  is  amongst  their  fibres  highly 
vascular. 

The  head  of  the  Femur  may  be  dislocated  in  the  ox,  dog,  and 
cat ;  but  in  the  horse  this  is  an  impossibility  without  fracture, 
owing  to  the  fact  that  in  the  horse  the  "  jJ2tk'o/emo?^«Z  ligament " 
is  found.  This  ligament  arises  from  the  head  of  the  femur,  passes 
from  the  acetabulum  through  the  cotyloid  notch,  then  runs  along 
a  grove  on  the  under  side  of  the  pubis  to  the  median  line,  where 
it  crosses  its  fellow  from  the  opposite  side,  forming  a  cross,  X» 
and  becomes  finally  lost  in  the  faschia  of  the  abdominal  muscles. 
In  this  manner  the  head  of  each  femoral  bone  is  kept  in  position 
by  the  muscles  of  the  opposite  side  of  the  abdomen.  Eeduc- 
tion  may  be  easily  effected  in  the  dog  and  cat  by  extension  and 
manipulation,  and  the  parts  maintained  in  position  by  a  stiff 
Burgundy  pitch  plaster ;  but  in  the  cow  any  treatment  may  be 
considered  questionable,  and  if  the  animal  is  at  all  fat,  she  should 
be  made  into  beef 

The  symptoms  of  this  dislocation  are  similar  to  those  of 
fracture,  but  there  will  be  no  crepitation.  As  a  rule,  in  the 
door  and  cat  the  dislocated  bone  wdll  be  found  on  the  dorsum 
of  the  ilium.  There  will  be  shortening  of  the  limb,  and  total 
inability  on  the  part  of  the  patient  to  perform  the  ordinary 
movements;  but  should  the  dislocation  be  into  the  foramen 
ovale,  the  limb  will  appear  longer  than  its  fellow,  and  the  foot 
turned  outwards. 

Dislocation  of  the  Carpus,  or  of  one  of  the  phalanges,  is  of  com- 

^  Note. — Since  the  above  has  been  in  type,  I  have  had  the  opportunity  of  dis- 
secting a  limb,  where  habitual  "knuckling  over"  at  the  fetlock  was  found  to  be 
due  to  an  arrested  development  of  the  extensor  suffrayinis.  The  tendon  of  this 
muscle  terminated  at  the  upper  head  of  the  metacarpus  parvus  extemus,  the  action 
of  the  extensor  muscle  thus  terminating  at  the  knee,  and  the  fetlock  knuckled  over 
from  the  want  of  the  support  of  its  tendon. 


LUXATIONS. 


mon  occurrence  in  running  dogs,  especially  greyhounds, 
easily  reduced,  but  is  very  apt  to  return. 


145 


It  is 


DISLOCATION  OF  THE  CERVICAL  VERTEBRAE  WITHOUT  FRACTURE. 

An  animal,  in  August  1871,  was  found  unable  to  rise  one 
morning,  but  with  some  assistance  was  got  on  to  its  feet,  when  the 
neck,  which  had  been  previously  all  right,  presented  the  apj)ear- 
ance  shown  in  the  annexed  woodcut  (Fig.  18).  Four  days  after- 
wards it  was  sent  to  the  College,  a  distance  of  about  two  miles, 
for  my  opinion.  The  animal  (an  old  mare)  walked  with  a  slight 
staggering  gait,  knuckled  over  occasionally  at  the  fetlocks,  could 
eat  well,  and  move  the  head  up  and  down  with  a  moderate 
degree  of  freedom.  There  was  no  swelling  of  the  soft  parts  from 
bruising  or  inflammation,  the  prominence  of  the  curve  being 


Fig.  18. 

hard  bone.  Upon  attempting  to  straighten  the  neck,  the  animal 
would  become  paralyzed  in  the  limbs,  this  paralysis  passing  away 
when  the  pressure  was  removed  from  the  neck.  Being  very  old, 
she  was  ordered  to  be  destroyed.     Wlien  the  neck  was  stretched 

L 


146  PAKTICULAK  FRACTURES. 

by  a  cord  to  the  wall,  previous  to  the  division  of  the  carotid 
artery,  she  fell  paralyzed,  and  died  before  she  was  bled. 

The  post  mortem  revealed  that  the  luxation  had  been  reduced 
by  the  stretching ;  that  the  fibro-cartilaginous  disc,  between  the 
third  and  fourth  cervical  vertebrse,  was  in  a  pulpy  condition; 
that  the  spinal  cord  and  its  surroundings  were  but  slightly 
affected ;  and  that  there  was  no  fracture.  This  case  proves  that 
there  can  be  luxation  without  fracture ;  that  such  a  lesion  does 
not  prove  fatal  if  the  spinal  cord  is  not  pressed  upon ;  and  that 
reduction — causing  pressure  upon  the  cord — may  be  followed  by 
immediate  death.  I  have  heard  of  similar  cases,  but  never  saw 
one  before.  I  have,  however,  seen  another  case  since  the  publi- 
cation of  the  first  edition  of  this  book. 

Twisted  or  wry  neck  may  occur  from  a  variety  of  causes  other 
than  dislocation,  such  as  over-stretching  or  bruising  of  the 
muscles  of  one  side  of  the  neck,  causing  inflammation ;  or  from 
rheumatism  affecting  them,  inducing  loss  of  function  of  the 
muscles  of  one  side  of  the  neck.  It  is  also  a  symptom  of  hemi- 
plegia. These  various  conditions  may  be  distinguished  from 
luxation  by  the  absence  of  the  diagnostic  symptom  of  the  latter, 
namely,  the  sudden  paralysis  of  the  limbs  when  attempts  are 
made  to  straighten  the  neck. 


FLATE  I 


■'^i^^i^t^ 


J^immss  ^  CctwanyJSottn^ 


DISEASES  OF  THE  BOI^ES  AITD  AETICULATIONS. 


EXPLANATION  OF  PHOTO-LITHOGRAPH,  PLATE  I. 

1.  Eragilitus  Ossium,  with  fracture  througli  the  body  of  the  foui'- 
teenth  dorsal  vertebra.  (1.)  Large  fragile  osseous  tumour.  (2.)  Line 
of  fracture. 

2.  Eheumatoid  Disease  of  Hip- Joint.  (1.)  Cotyloid  cavity,  show- 
ing porcellaneous  deposit.  (2.)  and  (3.)  Addimentary  bones,  partially 
filling  up  the  foramen  ovale. 

3.  Diseased  Condition  of  the  Os  Calcis  and  Astragalus,  pro- 
duced by  repeated  bruising,  the  animal  from  which  it  was  obtained 
being  a  vicious  kicker. 

4.  Osteophytes.  Through  the  centre  of  the  mass  a  canal  is  left  for 
the  passage  of  the  flexor  tendons,  blood-vessels,  and  nerves. 

5.  Ossification  op  the  Flexor  Brachii  in  chronic  shoulder  lame- 
ness. 

6.  Necrosis  Totalis  op  the  Scapula.  (1.)  and  (3.)  show  large 
cloacae  or  foramina  grandia.  (2.)  represents  the  sequestral  capsule. 
The  specimen  from  which  this  figure  was  taken  was  highly  priced  by 
Professor  Dick. 

7.  Caries  op  Superior  Maxillary  Bone  and  alveolar  processes, 
arising  from  disease  of  the  two  anterior  molar  teeth. 

8.  True  Mollities  Ossium,  or  softening  of  bone,  by  absorption  of 
the  earthy  salts,  without  alteration  in  animal  basis.  Case  described 
in  the  text. 

9.  Osteo-Sarcoma.  Lower  jaw  of  ox,  the  hollow  spaces  in  the 
specimen,  when  fresh,  being  fiUed  by  sarcous  material. 


CHAPTER  VIIL 

DISEASES  OF  THE  BONES  AND  ARTICULATIONS. 

CLASSIFICATION   OF   THE    BONES OSTITIS SORE    SHINS SPLINTS 

PECULIARITY  OF  SPLINT  LAMENESS — SCROFULOUS  OSTITIS. 

The  diseases  affecting  tbe  bones  of  the  lower  animals  may,  for 
the  convenience  of  description,  be  classified  under  two  heads, 
namely,  inflammatory  and  non-inflammatory.  The  line  of  de- 
marcation between  the  two  is  not  very  well  defined,  as  what  may 
be  essentially  a  non-inflammatory  disease  in  itself  might  be 
productive  of  inflammation.  Inflammation  of  bone  (ostitis)  can 
scarcely  be  considered  independently  of  inflammation  of  the  peri- 
osteum (periostitis),  as  both  structures  are  so  closely  related  that 
we  cannot  have  inflammation  of  the  one,  without  the  other  par- 
ticipating in  the  diseased  action. 

A  correct  knowledge  of  the  pathology  of  bone  being  of  the 
greatest  importance  to  the  veterinarian,  and  the  study  of  this 
particular  branch  of  veterinary  pathology  having  hitherto  been 
neglected  by  the  profession,  I  feel  it  necessary  to  give  a  slight 
outline  of  the  general  anatomy  of  bone,  in  order  that  its  patho- 
logy may  be  better  understood. 

Bones  are  divided  into  long,  short,  flat,  and  irregular.  "With 
the  exception  of  the  cranial  bones,  the  short,  irregular,  and  flat 
bones  are  composed  chiefly  of  cancellated  tissue  enclosed  in  a 
thin  shell ;  and  it  is  found  that,  owing  to  their  structure,  they,  as 
well  as  the  extremities  of  the  long  bones,  undergo  pathological 
changes  somewhat  similar  to  those  of  the  softer  structures. 

The  bones  of  the  cranium  are  composed  of  two  bony  plates — 
a  very  dense  one  internally,  another  less  dense  externally,  and 
an  intermediate  vascular  and  medullary  structure. 


CLASSIFICATION  OF  THE  BONES.  149 

The  long  bones  consist  of  a  shaft  and  two  extremities,  or 
epiphyses,  which  are  much  looser  in  structure  than  the  shaft, 
are  developed  separately  from  it,  and  are  supplied  by  numerous 
blood-vessels  passing  directly  into  them.  The  shaft  is  com- 
posed of  very  hard  tissue,  encloses  a  cavity  called  the  medul- 
lary canal,  and  on  its  outside  a  number  of  small  lines  or  grooves 
are  to  be  seen,  which  are  the  oblique  openings,  through  which 
vessels  pass  from  the  periosteum  into  the  dense  structure  of  the 
bone. 

The  bones  of  race-horses  contain  more  compact  tissue  in  their 
shafts  than  those  of  lower-bred  animals.  The  dense  struc- 
ture— compact  tissue — contains  the  Haversian  canals,  conveying 
blood-vessels ;  and  the  canaliculi,  which  are  smaller  canals  con- 
veying blood  plasma  to  the  lacunae.  In  this  manner  this  portion 
of  the  bone  receives  its  supply  of  nutritious  material  from 
the  blood,  and  without  this  arrangement  the  bony  structure  could 
not  receive  nutrition.  Each  Haversian  canal  is  about  -q^  of  an 
inch  in  diameter,  and  collectively  they  run  in  a  longitudinal 
direction,  but  have  many  transverse  branches  of  communication. 
The  canaliculi  average  ts-.-d^ott  of  ^^  i^ch  in  diameter,  and  appear 
as  dark  radiating  lines,  decreasing  in  diameter  as  they  recede 
from  the  lacunae ;  they  are,  along  with  the  lacunse,  filled  with 
the  fluid,  colourless  portion  of  the  blood. 

The  lacunse  are  irregularly  oval,  stellate,  dark-looking  bodies, 
lying  with  their  long  diameters,  which  are  about  i -gVo  ^^  ^^  inch, 
parallel  to  the  bony  lamellae.  Each  long  bone  is,  in  addition 
to  the  periosteal  vessels,  supplied  by  a  nutrient  artery,  which 
passes  directly  into  the  bone,  and  breaks  up  into  branches  in 
the  interior  of  the  medullary  canal. 

It  will  be  seen  that  the  compact  bone  is  abundantly  provided 
with  vessels,  entering  from  numerous  points,  covered  by  perios- 
teum and  endosteum;  that  these  nutrient  vessels  are  exceed- 
ingly minute,  and  surrounded  by  a  dense  structure ;  and  that, 
in  consequence  of  this  peculiarity,  the  effects  of  inflammatory 
action  wiU  be  very  distinctive,  and  the  symptoms  most  acute. 
Fortunately,  however,  inflammation  of  the  shafts  of  the  long 
bones  is  exceedingly  rare  in  the  lower  animals.  The  extremi- 
ties or  epiphyses  of  the  shaft  are,  as  already  stated,  developed 
separately  from  the  shaft,  and  they  exceed  it  in  circumference, 
are  irregular  in  outline,  expanded,  roughened  externally,  and 


150  DISEASES  OF  THE  BONES  AND  ARTICULATIONS. 

composed  of  cancelli,  with  a  very  thin  layer  of  corapact  tissue. 
Whilst  they  are  of  greater  circumference,  their  weight  is  not 
relatively  greater  than  the  shaft,  their  increase  being  due  to 
an  expansion  of  substance.  This  arrangement  lightens  and 
strengtliens  the  bone,  and  modifies  inflammatory  action,  which 
consequently  partakes  more  of  the  nature  of  that  of  the  soft 
tissues. 

The  hardest  part  of  tlie  bone  is  a  thin  laminal  layer,  lying 
next  to  the  articular  cartilage.  It  is  non- vascular,  insensible, 
and  destitute  of  Haversian  canals,  and,  in  inflammatory  disease 
of  the  articulations,  it  is  affected  in  a  remarkable  way,  which 
will  be  referred  to  hereafter. 

Each  long  bone  has  a  canal  in  the  centre  of  its  shaft,  called 
the  medullary  canal,  which  is  not  continued  to  the  extremities. 
It  contains  medulla  or  marrow,  and  is  lined  by  a  delicate 
vascular  membrane,  the  endosteum,  which  is  prolonged  into 
the  cancellated  structure  and  Haversian  canals.  It  is  supplied 
with  blood  by  the  nutrient  arteries,  which  anastomose  with 
those  supplied  by  the  periosteum. 

The  periosteum  invests  the  whole  bone,  except  its  articular 
extremities.  It  is  a  complex  structure,  consisting  of  a  fibrous 
membrane,  and  a  lining  of  germinal  or  nucleated  membrane ; 
both  of  which  are  continued  into  the  Haversian  canals.  This 
inner  lining  assists  in  the  formation  of  new  bone,  but  the 
fibrous  portion  has  no  formative  power. 

Many  experiments  have  been  made  to  prove  that  the 
periosteum  possessed  this  formative  power,  but  they  are  stiU 
inconclusive ;  and  the  only  practical  deduction  obtained  is, 
that  when  it  is  destroyed,  there  is  a  want  of  nutrition  and 
reproductive  power,  in  proportion  to  the  destruction  of  the 
formative  membrane  and  the  vessels  passing  along  with  it  to 
the  substance  of  the  bone. 

The  presence  of  this  formative  membrane,  internal  to  the 
fibrous  coat,  will  at  once  explain  how  subperiosteal  exudation, 
as  in  the  case  of  splints  and  other  exostoses,  is  converted  into 
bony  structure. 

Having  in  view  aU  the  peculiarities  of  structure  found  in 
the  various  bones,  we  will  now  consider  the  diseases  aff^ecting 
them. 


OSTITIS.  151 


OSTITIS,  OR  INFLAMMATION  OF  BONE, 

May  be  acute  or  chronic.  It  may  involve  the  whole  substance 
and  extent  of  a  bone,  or  it  may  be  confined  to  a  portion  of  it 
(circumscribed  inflammation).  The  causes  are  external  injury, 
concussion,  and  hereditary  tendency. 

Acute  inflammation  of  bone,  involving  the  shaft,  is  found  to 
affect  young  race-horses  in  the  disease  termed  "  sore  shins." 
This  disease  usually  involves  the  periosteum  and  external 
layer  of  the  bone  only;  and  such  cases  terminate  by  a 
deposition  being  thrown  out  between  the  periosteum  and  the 
bone,  which,  becoming  organized,  forms  a  permanent  thicken- 
ing, depending  more  or  less  upon  the  degree  of  the  diseased 
action;  but  in  rare  cases  the  whole  of  the  bone  is  afi'ected, 
and  the  inflammation  is  of  such  an  acute  nature  that  the 
vitality  of  the  bone  is  destroyed;  the  exudation  blocking  up 
the  Haversian  canals  and  canaliculi,  and  thus  arresting  the 
nutritive  functions.  The  dense  structure  of  the  bone  does  not 
permit  the  blood-vessels  to  relieve  themselves  by  pouring  out 
their  liquid  contents,  as  in  the  softer  tissues,  and  the  part  dies 
by  the  pressure  on  its  vessels,  even  when  the  diseased  action  is 
not  sufficiently  active  to  produce  this  death  of  the  bone.  Ac- 
cording to  Goodsir,  the  first  changes  that  occur  in  the  bone  are 
to  be  distinguished  within  the  Haversian  canals.  These  dilate 
or  become  opened  up ;  and  the  result  of  this  is  the  conversion 
of  the  contiguous  canals  into  one  cavity,  and  the  consequent 
removal  or  absorption  of  all  the  osseous  texture  of  the  part. 

Concurrent  with  this  softening  and  opening  up  of  the 
bony  texture,  an  external  swelling  makes  its  appearance ;  the 
vessels  of  the  periosteum  and  contiguous  soft  parts,  becoming 
involved,  throw  out  a  deposit  upon  the  surface  of  the  bone. 
This  exudate,  as  a  rule,  becomes  converted  into  bone,  leaving 
the  parts  permanently  altered  in  shape  and  appearance ;  or  it 
may  become  absorbed  before  it  is  ossified,  and  the  parts  regain 
their  former  condition. 

The  results  of  inflammation  of  bone,  where  resolution  does 
not  take  place,  are  either  an  increased  condensation  or  an 
abnormal  rarefaction.  Of  both  these  forms  we  have  good  in- 
stances in  most  cases  of  ostitis,  whether  occurring  in  the 
navicular  or  other  bones.     (See  figures  of  Navicular  Bones.) 


152 


DISEASES  OF  THE  BONES  AND  ARTICULATIONS. 


In  the  first  form,  the  Haversian  canals  and  the  cancellated 
spaces  are  blocked  up  by  earthy  matters,  which  give  to  the  bone 

an  ivory-like  appearance  when 
sawn  across ;  at  the  same  time 
the  bone  is  heavier  and  denser. 
In  the  latter,  or  rarefaction  of 
bone,  there  is  a  diminution  of 
its  density  and  weight,  owing 
to  its  tissues  being  expanded, 
and  to  its  canals  and  cells  beini^ 
enlarged,  Avith  thinning  of  its 
osseous  layers,  and  the  forma- 
tion of  communications  between 
^      ,nTr.        .      .,      ^xM .    its  various  interspaces.    Whilst 

r  IG.   19. — inferior  extremity  of  tibia      ,  .     .  . 

in  a  healthy  condition,    a,  Laminai  layer.    thlS  IS  gOing  On,  the   OUtcr   SUr- 
h,  CanceUated  tissue.  f^^.^   q£   ^^^^   j^^^^g    ^^y.  \)qqqj^q 

thickened  by  a  deposition  of  new  bone,  or  it  may  be  removed 
by  absorption ;  or  both  conditions  may  be  co-existent  upon  the 

same  surface  of  the  bone 
(see  Fig.  20).  Of  this  we 
have  other  examples  in 
navicular  disease,  where 
small  nodules  of  bony  mat- 
ter are  often  found  conti- 
guous to  a  pit-hke  ulcer. 
Again,  it  is  generally  found 
that  when  this  loss  of  sub- 
stance goes  on  w^ithin  the 
bone,  and  upon  its  articular 
surface,  as  in  ostitis  caused 
by  open  joint,  that  there  is 
an  active   process  of  de- 

FlG.    20. — Interior  extremity  of  tibia  in  a 
state  of  ulceration,    a,  Thickened  laminai  layer.    pOSltlOU     gomg     On     upOU 
h,  Carious  spot,     c,  Cancellated  tissue  opened    its  periosteal  SUrface  ;    and 

this  may  be  looked  upon 
as  a  process  of  repair  contemporary  with  that  of  destruction. 
During  the  early  stages  of  the  process  of  rarefaction,  the  bony 
texture  is  found  softened,  and  has  a  porous  appearance;  but 
later  on  the  effect  is  to  render  the  whole  substance  of  the  in- 
flamed part  more  brittle  and  liable  to  fracture,  as  in  the  case  of 
"  fractured  spavin,"  fractured  navicular  bone,  &c. 


OSTITIS.  153 

The  outer  surface  of  the  inflamed  bone  presents  a  spongy- 
appearance,  from  a  deposition  of  new  bone ;  the  periosteum  is 
thickened,  and  in  the  more  acute  cases  it  is  detached  from  the 
bone,  which,  when  exposed,  has  a  white  and  smooth  appearance, 
with  hardly  any  change  in  its  structure,  the  diseased  action 
having  been  too  rapid  to  allow  it  to  open  out. 

When  the  inflammation  is  of  the  chronic  form,  the  patholo- 
gical changes  occur  more  slowly,  and  when  different  parts  of  a 
bone  are  aftected,  new  osseous  material  is  deposited  here  and 
there,  giving  the  bone  an  irregularity  of  shape,  as  in  multiple 
splints. 

A  very  moderate  degree  of  inflammation  in  the  outer  lamella 
of  bone,  produces  a  gelatinous,  dark  red  exudation,  which  gradu- 
ally changes  its  colour  to  bluish-red  and  reddish-white,  and  at 
length  becomes  quite  white ;  at  the  same  time,  passing  from  its 
original  gelatinous  condition,  it  forms  a  coagulum,  like  the  white 
of  an  egg,  then  becomes  a  soft  flexible  cartilage,  and  finally 
reddish-white  succulent  bone.  In  this  state  it  invests  the  bone, 
and  constitutes,  according  to  its  quantity,  either  a  white,  porous, 
and  scarcely  perceptible  film,  or  a  thicker  layer,  that  resembles 
felt  or  velvet.  The  periosteum  appears  at  first  injected,  bluish- 
red,  infiltrated,  and  decidedly  swollen,  and  generally  has  but  a 
loose  connection  with  the  exudation.  The  ossified  exudation 
unites  with  the  surface  of  the  bone,  and  either  forms  uninter- 
ruptedly an  addition  to  the  compact  wall,  or  is  connected  with 
it  by  a  spongy  layer  (diploetic).  The  inflammation  may  recur  in 
the  exudation  at  any  period  of  its  existence,  leading  to  a  corre- 
sponding increase  in  its  size. 

Such,  then,  are  the  general  outlines  of  the  various  changes  that 
occur  consequent  upon  inflammation  of  bone. 


OSTITIS  AND  PERIOSTITIS  OF  THE  METACARPAL  BONES,  OR 

"  SORE  SHINS." 

This  is  a  form  of  disease  affecting  the  metacarpal  bones  of 
young  horses,  particularly  race-horses  under  four  years  old,  and 
is  due  to  the  fact  that  they  are  called  upon  to  perform  an 
amount  of  work  at  an  age  when  the  condition  of  their  bones  is 
totally  unfit  to  bear  it. 

The  bones  of  the  young,  being  in  a  state  of  development 


154 


DISEASES  OF  THE  BONES  AND  ARTICULATIONS. 


and  growth,  are  much  more  vascular,  and  contain  a  greater 
quantity  of  animal  matter  than  the  bones  of  those  of  mature 
age ;  they  are  consequently  unable  to  stand  the  shocks  of  con- 
cussion, to  which  they  are  subjected  in  their  training. 

Sore  shins  may  affect  the  whole  shaft  of  the  bone  (see  Yig.  21), 
and  may  be  so  excessive  as  to  cause  necrosis  to  supervene ;  but 
usually  the  inflammation  is  circumscribed  and  confined  to  the 
lower  extremity  and  anterior  portion  of  the  bone.     The  leg  with 

which  the  animal  leads  in  the  gallop  is 
more  liable  to  be  affected  than  its  fellow. 
Symptoms. — Lameness  occurring  after 
a  gallop,  insidious  at  first;  the  horse 
restless,  shifting  his  weight  from  one 
leg  to  the  other  if  both  legs  are  affected, 
or,  if  only  one,  standing  with  his  foot 
pointed.  If  the  inflammation  is  acute, 
there  will  be  fever,  with  acceleration  of 
the  pulse  and  respiratory  movements,  and 
the  bones  are  sensitive  when  pressed 
upon.  Swelling  is  an  early  symptom;  at 
first  it  is  elastic,  tense,  and  doughy  to  the 
touch ;  it  depends  on  the  thickening  of 
the  periosteum  ;  and  on  the  presence  of 
a  subperiosteal  exudate ;  afterwards,  the 
swelling  may  become  oedematous,  from 
effusion  into  the  areolar  tissue  external 
to  the  periosteum,  but  it  always  main- 
tains the  elastic  feel  underneath  the 
oedema. 

If    the    subperiosteal    exudation    is 

very  great,  and  the  swelling  involves  a 

large  extent  of  the  surface  of  the  bone, 

the    most    active    treatment    must    be 

employed  in  order  to  prevent  necrosis. 

In  some  rare  cases,  the  exudate  becomes 

converted  into  a  thin,  sanious  matter, 

which  corrodes  the  surrounding  tissues, 

causing  great  febrile  disturbance,  and  may  cause  the  death  of 

the  patient,  from  its  absorption  into  the  general  circulation. 

In  the  less  acute  cases,  where  the  cause  has  been  less  severe, 


Fig.  21. — Sore  shin. 


OSTITIS  AND  PERIOSTITIS  OF  THE  METACARPAL  BONES.       155 

the  disease  is  more  circumscribed  and  more  limited  in  its 
effects,  or  the  limbs  of  the  animal  have  been  more  able  to  bear 
it ;  it  becomes  ultimately  quite  hard,  from  the  organization  of 
the  exudate  into  bony  matter,  and  when  this  is  effected,  the 
lameness  and  pain  generally  disappear. 

In  the  acute  and  extensive  form,  when  the  exudate  does  not 
break  down  into  sanies,  or  when  suppuration  does  not  imme- 
diately take  place,  it  becomes  after  a  time  hardened,  and  finally 
converted  into  an  ensheathing  ring  or  case  of  new  bone  around 
the  old  bone,  forming  a  support  for  the  limb,  as  will  be  de- 
scribed under  Necrosis. 

The  treatment  of  the  acute  form  is  by  free  subcutaneous 
incisions  through  the  periosteum ;  this  will  relieve  the  pain,  cut 
short  the  disease,  and  by  allowing  the  exudate  to  escape,  will 
prevent  the  separation  of  the  periosteum  from  the  bone,  a  result 
to  be  dreaded  in  every  acute  case,  as  leading  to  the  necrosis  of 
the  bone  by  the  removal  of  its  blood  supply.  In  addition  to 
this,  warm  and  soothing  fomentations  are  to  be  used  at  first, 
succeeded  by  cold,  and  afterwards  by  blisters.  The  constitu- 
tional treatment  to  consist  of  a  smart  purgative,  followed  by 
alteratives  or  sedatives,  with  low  diet,  and  the  animal  to  be 
kept  as  quiet  as  possible.  In  the  less  severe  form,  incisions 
are  not  called  for,  and  the  cold  application  may  be  employed 
from  the  outset,  succeeded  by  blisters,  as  in  the  acute  form. 

SPLINTS 

Are  another  form  of  ostitis  and  periostitis,  affecting  the 
metacarpal  bones,  and,  in  rare  instances,  the  metatarsals.  They 
have  a  great  analogy  to  the  last-named  disease,  differing 
only  in  situation ;  splints  being^  usually  found  upon  the  inner 
surface  of  the  leg,  involving  the  inner  small  and  large  meta- 
carpal bones,  whereas  the  other  form  is  usually  found  upon  the 
surfaces  of  the  lower  third  of  the  large  bone  only.  The  reason 
for  this  may  be  found  in  the  pace  of  the  race-horse  being  the 
gallop,  in  which  the  weight  of  the  animal's  body  is  thrown 
upon  the  anterior  portion  of  the  bone  with  fearful  velocity  at 
each  successive  bound,  causing  the  inflammation  of  the  bone 
in  that  part  by  which  the  shock  is  received.  Splints,  on  the 
other  hand,  are  caused  by  a  moderate  pace,  the  trot  or  gentle 


156 


DISEASES  OF  THE  BONES  AND  ARTICULATIONS. 


gallop,  where  the  animal  is  more  kept  up  to  the  bridle,  and 
the  weight  thus  thrown  more  directly  upon  the  upper  extremity 
of  the  bone,  and  is  thence  transmitted  to  the  seat  of  splint,  in 
the  same  way  as  a  blow  will  cause  an  indirect  fracture,  as  already 

explained.  As  a  rule,  the  inner  side 
of  the  upper  third  of  the  metacarpals 
is  the  seat  of  splint ;  but,  owing  to 
peculiarity  of  form  and  shape  of  the 
leg,  the  deposit  may  be  found  upon  the 
outer  side,  or  both  upon  the  inner  and 
outer,  and  middle  aspect  of  the  limb. 
Percivall  describes  five  classes  of  splints : 
1st.  Simple.  i 

2d.  Double  or  pegged  splints  ;  that 
is,  those  which  are  found  upon  both 
aspects  of  the  limb,  with  an  osseous 
communicating  bar  running  from  one 
to  the  other. 

3d.  Those  close  to  the  knee. 
4:th.  Consisting    of    two    or    more 
exostoses  upon  one   side  of  the  leg, 
one  above  the  other,  with  perhaps  an 
osseous  communication. 

5th.  Little   bony   excrescences,  in- 
volving the   knee-joint,   namely,   the 
head  of  the  metacarpus  minor  inter- 
involving  the  three  metacarpal  ^^^s,    and    trapezoid,    or    metacarpus 

bones,  a, Inter-metacarpal  groove,  minor  CXtemUS,  and  unciform, 
presenting  a  smooth  healthy  sur-         a       •        i  t    4.        i  j. 

face.  b,%  Osseous  deposit,  in-  ^  Simple  sphut,  when  uot  causmg 
voiving  the  extremities  of  the  lameness,  and  in  a  position  removed 

metacarpal    and    superior    sesa-  r.  ^.^  .  •      i    j. •  j^       i 

moideanligaments.  c,  c,  c,Irregu- ^^'0^   either   artlCulatlOU   Or  teudou,  IS 

lar  ossifications,  involving  the  not  looked  upon  as  an  uusouudness, 

small  metacarpals,  lower  end  of  ,      .      ,,    .-,  .-,         r,  ,   ■,         -, 

large   metacarpal,   and    forming  L>ut  all  tue  Other  lomiS.must  be  claSSl- 

points  of  attachment  to  tiie  supe-  fied  as  causcs  of  imsoundness,  as  they 

rior  sesamoidean  ligament  above  .  . .  tit,  i 

its  bifurcation.  are  at  any  time  liable  to  cause  lame- 

NoTE.-The  more  impnrfant  por-  ucss*;    and    are    iudicativc    of    more 

tions  of  this   form  of  splint,   namely,      .  ,  .  •        'ii  •        ^ 

those  involving  the  ligamentous  strnc-  discase  than  IS  apparent  cithcr  to  the 

tures,   are    hidden   from   view  in  the  i        /»  ■  i  •  t 

living  subject.  ejQ  OT  toucli  01  tlic  examiuer  ;  disease 

involving  articulating  surfaces,  ligamentous  structures,  or  inter- 
fering with  the  movement  of  a  tendon. 


Fig.    22. — Compound  splint, 


SPLINTS.  157 

Professor  Dick  taught  tliat  a  splint  never  interfered  with  tlie 
action  of  the  flexor-pedis  tendon ;  that  the  soft  parts  adapted 
themselves  to  the  hard ;  and  that,  although  a  splint  might  press 
upon  the  tendon,  a  corresponding  hollow  was  made  for  it  by 
absorption  of  the  softer  structure.  I  cannot  agree  with  this. 
Experience  has  proved  to  me  that  it  is  wrong,  and  that  the 
lameness,  depending  upon  the  interference  of  the  splint,  can  be 
completely  cured  by  the  removal  of  the  deposit. 

A  simple  splint  on  the  outer  side  of  the  leg  is  more  apt  to 
cause  lameness  than  one  on  the  inner  side. 

The  causes  of  splints  are  concussion  and  hereditary  predis- 
position, more  especially  that  arising  from  shape  and  form  of 
leg,  wdiich  descends  from  parent  to  offspring. 

Splints  are  most  generally  found  in  horses  that  are  newly 
put  to  work,  or  they  may  arise  in  the  unbroken  colt  when  he 
is  allowed  to  gallop  and  play  in  the  fields.  The  class  of  horse 
most  subject  is  the  lighter-bred  horse,  or  that  which  is  called 
upon  to  go  beyond  a  walking  pace.  Heavy  cart-horses  seldom 
have  splints ;  but  I  see  no  reason  why  they  should  not,  provided 
their  legs  were  subjected  to  the  same  amount  of  concussion. 

Splints  are  exostoses  due  to  a  circumscribed  superficial  in- 
flammation of  the  bone  and  periosteum,  and  not  inflammation 
of  the  interosseous  ligament,  as  described  by  some  writers. 
^N'umerous  specimens  in  the  College  Museum  prove  the  cor- 
rectness of  this  view.  The  effects  of  the  concussion  which 
produces  this  form  of  ostitis  may  be  due  to  the  immature  age 
of  the  bone,  to  peculiarity  of  shape  in  the  leg,  to  the  method 
by  which  the  animal  is  shod,  or  to  w^ork  at  an  early  age.  Old 
horses  throw  out  splints  occasionally. 

Splints  do  not  always  produce  lameness.  If  of  the  simple 
kind,  when  the  horse  is  very  young,  and  before  he  is  broken  in, 
lameness  is  but  seldom  seen ;  and  when  over  six  or  seven  years 
of  age,  he  seems  exempt  from  lameness,  although  the  deposit 
might  be  of  considerable  size. 

When  simple  splints  cause  lameness,  it  is  during  their  forma- 
tion, that  is,  during  the  inflammatory  stage,  9,nd  before  the 
periosteum  has  adapted  itself  to  the  pressure.  The  young 
horse  of  good  action  is  the  one  most  likely  to  suffer,  as  the 
effects  of  shock  or  concussion  are  greater  and  more  destructive 
to  his  limbs  than  to  the  limbs  of  a  horse  with  lower  action. 


158 


DISEASES  OF  THE  BONES  AND  ARTICULATIONS. 


PECULIARITY  OF  SPLINT  LAMENESS. 

The  lameness  may  precede  the  ap- 
pearance of  any  swelling  or  deposit,  and 
in  such  a  case  it  is  apt  to  be  confounded 
with  that  arising  from  other  diseases. 
But  if  the  following  observations  are 
kept  in  remembrance,  no  mistake  need 
be  made : — 

1st.  The  age  of  the  animal.  The 
young  horse  is  most  liable  to  splint 
lameness,  the  older  horse  to  navi- 
cular disease. 

2d.  The  peculiarity  of  action.  A 
horse  lame  from  splint  will  walk  ap- 
parently or  nearly  sound,  but  will 
trot  very  lame,  the  droj?  of  the  head 
and  body  upon  the  sound  side  being 
very  great,  and  out  of  all  proportion 
to  the  apparent  soimdness  of  the  walk. 

Sd.  A  want  of  flexion  may  be  ob- 
served at  the  knee. 

4:th.  When  the   patient   first   comes 

fore  leg    involving    the   large    ^    -     ^^^    -g    ^^^^    ^^    ^^^^    j^^    j^^^y   gO 
and  small  metacarpals.    In  the  '  . 

original  specimen  the  inter-  moderately    sound,   but    after   a   time 
osseous  ligament  is  not  ossified.  ^^^  lameness  increases,  the  concussion 

being  a   cause  of  pain.      In   navicular   disease   the  lameness 
generally  decreases  with  exercise. 

5th.  Pressure  upon  the  part  of  the  leg  where  splint  is  likely 
to  be  will  cause  pain ;  some  heat  is  present ;  and,  by  a  careful 
manipulation,  a  hard  swelling  perhaps  smaller  than  a  pea  may  be 
felt.  In  some  cases  the  exostoses  soon  develop  themselves,  and 
then  there  can  be  no  further  difficulty ;  but  in  others,  this  does  not 
occur  for  several  weeks,  and  these  are  most  unsatisfactory  to  the 
surgeon.  In  some  rare  cases  the  lameness  is  very  excessive, 
the  horse  being  scarcely  able  to  put  any  weight  upon  the 
affected  limb ;  standing  with  the  toe  only  touching  the  ground, 
with  great  heat  and  swelling  of  the  part  affected,  at  the  same 
time  suffering  from  constitutional  disturbance  to  a  considerable 
degree.      In  such  a  case,  the  treatment  must  be  prompt,  to 


Fig.  23. — Ordinary  form  of 
splint  on  the  inner  side  of  near 


PECULTAEITY  OF  SPLINT  LAMENESS.  159 

relieve  the  animal  from  its  sufferings,  and  the  best  is  "  sub- 
cutaneous periostiotomy,"  as  recommended  by  the  late  Professor 
Sewell. 

The  operation  is  performed  by  making  a  transverse  incision 
with  the  rowelling  scissors,  immediately  below  the  enlargement, 
introducing  the  "  periostiotomy  knife  "  flatwise  under  the  skin, 
as  far  as  the  upper  end  of  the  splint,  turning  the  cutting  edge 
inwards  on  to  the  bone,  and  cutting  through  the  periosteum 
into  the  new  formation.  It  may  be  necessary  to  cast  the  horse, 
but,  as  a  rule,  the  aj)plication  of  the  twitch  keeps  him  quiet 
enough. 

Some  practitioners  pass  a  seton  over  the  deposit  after  the 
operation,  and  I  recommend  it  as  good  practice. 

In  all  cases  a  purgative  must  be  administered ;  and  in  the 
milder  forms,  fomentations  and  the  application  of  a  coolino- 
lotion  are  quite  sufficient  to  remove  the  inflammation  and 
lameness ;  but  if  they  fail  to  do  so,  a  blister  should  be  applied,' 
and  in  obstinate  cases  it  may  be  found  necessary  to  fire  the 
part,  the  method  by  pyro-puncture  being  preferable,  as  it  leaves 
but  little  blemish ;  the  instrument  to  be  made  hot,  and  applied 


Fig.  24. — Instrument  for  pyro-puncture. 

with  sufficient  pressure  to  pierce  the  skin,  and  to  enter  the  new 
deposit. 

If  there  be  a  return  of  lameness  when  the  patient  is  put  to 
work  after  an  apparent  cure,  it  will  be  advisable  to  take  the 
shoes  off,  turn  him  into  a  loose  place,  and  allow  a  long  rest. 
When  the  deposit  is  sufficiently  prominent  to  interfere  with 
the  action  of  the  flexor  tendon,  the  treatment  is  to  cut  down 
upon  it  and  remove  it  by  the  bone  forceps. 

Sometimes  the  splint  is  large  enough  to  interfere  with  the 
action  of  the  opposite  fore  foot,  that  is  to  say,  it  is  liable  to 
be  struck  by  the  other  foot  during  rapid  action.  In  such  a 
case  a  boot  must  be  used,  and  the  absorption  of  the  deposit 
excited  by  the  application  of  the  ointment  of  the  biniodide 
of  mercury ;  or  if  it  be  a  sharp,  prominent  splint,  it  is  to  be 
removed  by  the  bone  forceps.  This  striking  of  the  enlarge- 
ment with  the  opposite  foot  is  apt  to  cause  the  horse  to  fall, 


160  DISEASES  OF  THE  BONES  AND  ARTICULATIONS. 

from  the  suddenness   and  violence   of  the  pain,  or  to  induce 
inflammation  in  the  splint,  and  very  severe  lameness. 

Splints  in  the  hind  legs  seldom  cause  lameness;  they  are 
usually  upon  the  outer  side  of  the  metatarsal  bone.  There  are 
many  examples  of  ostitis  that  will  be  described  more  appro- 
priately under  the  head  of  lameness.  Sore  shins  and  splints 
are  perhaps  the  only  ones,  usually  met  with  in  practice,  of  in- 
flammation of  the  compact  shaft  of  the  bone ;  the  other  forms  being 
found  attacking  the  cancellated  structure  composing  the  short 
and  irregular  bones,  and  the  extremities  of  the  long  ones.  But 
before  passing  on  to  these,  I  shall  describe  scrofulous  inflamma- 
tion of  bones,  caries,  necrosis,  and  the  non-inflammatory  diseases. 


SCROFULOUS  OSTITIS  IN  YOUNG  ANIMALS. 

Scrofulous  ostitis  is  found  in  very  young  animals,  usually  in 
those  of  a  few  days  or  weeks  old.  I  have  seen  it  in  foals,  calves, 
and  lambs,  and  in  older  animals,  as  malignant  "  foul  in  the  foot " 
of  horned  cattle.  Professor  Dick  taught  that  pigs  were  subject 
to  it.  The  following  is  the  pathological  anatomy  of  a  case  of 
"  foul  in  the  foot "  arising  from  scrofula,  occurring  in  my  own 
practice. 

The  animal  was  a  two-year-old  heifer,  which  had  been  sufl*er- 
ing  for  about  five  months  from  foul  of  the  foot ;  having  defied 
all  the  ordinary  remedies  to  effect  a  cure,  and  the  fact  that 
several  animals  on  the  same  farm,  and  of  the  same  breed,  were 
similarly  effected,  induced  the  veterinary  surgeon  in  attendance 
to  send  one  of  the  affected  feet  of  this  malignant  case  to  the 
Collecje  for  examination. 

The  part  sent  was  a  fore  foot,  having  been  cut  through  about 
the  lower  third  of  the  metacarpus,  showing  the  fetlock  joint  and 
the  two  complete  digits  attached. — (See  Photo-lithograph,  Plate 
II.,  Pigure  9.) 

In  external  appearance  it  was  very  much  swollen,  and  studded 
round  with  ulcers  of  various  shapes  and  sizes,  from  that  of  a  six- 
pence to  that  of  a  halfpenny.  The  fetlock  joint  was  completely 
open  on  the  right  side,  and  deep  ulcerations  of  the  articular  sur- 
faces of  the  bones  had  taken  place,  more  particularly  of  the 
trochlea  of  the  metacarpus. 

On  attempting  to  remove  the  skin,  it  was  found  closely  ad- 


SCROFULOUS  OSTITIS.  161 

herent  to  the  subcutaneous  tissue,  and  intimately  blended  with 
it.  The  subcutaneous  substance  consisted  of  an  inflammatory 
exudate  of  considerable  thickness,  having  a  pale  bluish  appear- 
ance, a  vitreous  character,  and  quite  structureless ;  it  was  so 
intimately  infiltrated  within  the  textures  of  the  tendons  and 
ligaments  beneath,  that  it  was  with  difficulty  detached  from 
them. 

ThrouQ-hout  this  exudate  were  a  number  of  sinuses  of  various 
sizes  and  figures,  containing  a  yellow  semi-fluid,  granular-look- 
ing substance,  which,  on  examination  with  the  microscope,  pre- 
sented all  the  characteristic  appearances  of  tubercular  pus,  and 
a  very  few  titbercle  corpuscles  mixed  with  it. 

The  cavities  in  which  the  substance  was  contained  varied  in 
size  from  a  pin-head  to  fhat  of  a  hean,  the  smaller  ones  being  for 
the  most  part  circular  in  figure,  while  the  larger  ones  varied  very 
much,  their  form  and  outline  making  it  evident  that  their  en- 
largement was  due  to  the  confluence  of  two  or  more  smaller 
ones.  Notwithstanding  the  number  of  these  little  cavities,  there 
was  very  little  of  that  apparent  inflammation  in  the  immediately 
surrounding  textures  which  we  invariably  find  in  the  formation 
of  an  ordinary  abscess. 

On  making  a  longitudinal  section  of  the  bones,  I  found  in  the 
first  or  upper  phalanges  not  only  the  medullary  canal  filled  with 
lymphoid  material,  but  the  whole  of  the  cancellated  tissue  en- 
tirely replaced  by  that  substance.  The  bones  of  the  second  or 
middle  phalanx  also  contained  a  considerable  quantity  of  it,  but 
there  was  no  ulceration  of  the  articular  extremities.  There  was 
a  slight  calcareous-looking  deposit  on  the  bones  of  the  first 
phalanx,  but  on  examination  it  had  no  bony  structure. 

The  old  writers  described  this  disease  as  "joint-ill,"  and 
ascribed  it  to  rheumatism.  I  ain  of  opinion  that  they  were 
wrong,  as  in  its  progress  it  differs  most  materially  from  rheuma- 
tism. If  the  patient  be  under  three  or  even  four  weeks  old,  the 
first  noticeable  sign  of  the  disease  is  a  dribbling  of  urine  from 
the  umbilical  cord.  In  fact,  the  urachus  has  again  become  per- 
vious, and  allows  the  urine  to  escape,  although  the  urethra  is 
quite  in  a  normal  condition,  the  animal  having  been  seen  to 
urinate  in  a  proper  manner.  Concomitant  with  this  unnatural 
flow  of  urine,  the  patient  will  be  found  stiff  and  lame  in  one,  two, 
or  more  of  its  limbs  or  joints ;  the  affected  parts  are  swollen, 

M 


1 C2  DISEASES  OF,  THE  BONES  AND  ARTICULATIONS. 

liot,  and  tender ;  the  respirations  hurried ;  but  the  appetite  re- 
mains tolerably  good  for  some  time ;  the  swollen  joints  suppur- 
ate; and  the  disease  is  now  complicated  with  open  joint;  abscesses 
form  on  various  parts  of  the  body,  the  patient  loses  flesh,  be- 
comes unable  to  rise,  and  dies,  a  miserable  object. 

The  causes  are  extrinsic  and  intrinsic. 

The  extrinsic  are  exposure  to  cold,  a  bad  mother — that  is  to 
say,  a  mother  that  is  without  sufficient  milk  for  the  foal — long 
fasting,  as  in  cases  where  the  mother  is  put  to  work  shortly 
after  the  birth  of  the  foal,  and  only  allowed  to  suckle  her 
young  two  or  three  times  a  day.  I  have  seen  the  disease 
produced  in  pet  lambs  wdien  brought  up  on  cow's  milk ;  these 
circumstances  produce  debility  of  the  constitution,  indigestion, 
and  mal-assimilation.  • 

The  intrinsic  cause  is  the  scrofulous  diathesis,  and  this  may 
arise  independently  of  any  external  circumstances. 

Pathology. — To  understand  this  correctly,  it  must  be  re- 
membered that  the  grow^th  of  the  bones  is  very  rapid  in  young 
animals,  and  that  a  large  quantity  of  blood  is  required  in  the 
part,  in  order  to  supply  the  nutritive  plasma  for  such  growth ; 
in  fact,  the  bones,  more  particularly  their  extremities,  are  in  a 
state  of  healthy  congestion.  The  blood  supply  must  be  abun- 
dant in  quantity,  and  healthy  in  quality ;  but  in  this  disease 
the  latter  condition  is  absent ;  and  instead  of  supplying  healthy 
material  for  the  growth  and  nourishment  of  the  bones,  it  con- 
veys a  degraded  form  of  an  albuminoid  matter,  wdiich  is  de- 
posited in  the  structure  of  the  bones,  and  there  excites  a  form 
of  strumous  inflammation  leading  on  to  caries,  the  removal  of 
the  articular  cartilage,  and  the  formation  of  abscesses  in  and 
around  the  joints,  which  make  their  way  through  the  ligaments 
and  synovial  membrane,  and  burst  externally  by  many  openings, 
which  communicate  with  the  joint  by  circuitous  sinuses.  At 
the  same  time  tubercular  material  is  deposited  in  the  cancelli 
of  the  bone,  which  is  also  found  abnormally  vascular  and  much 
softened.  The  urachus  is  also  filled  with  a  deposit  of  this 
tubercular  matter,  wliich,  by  preventing  the  completion  of  the 
process  of  adhesion  naturally  taking  place  between  its  walls, 
allows  the  escape  of  the  urine  at  the  umbilical  region. 

The  probabilities  of  effecting  a  cure  will  much  depend  upon 
the  severity  and  situation  of  the  arthrodial  inflammation.     If 


SCROFULOUS  OSTITIS.  163 

the  larger  joints,  or  those  having  extensive  motion,  as  the  true 
hock-joint  or  elbow,  be  already  opened  by  the  suppuration,  the 
case  may  be  looked  upon  as  hopeless. 

If  treatment  is  to  be  adopted,  it  must  in  the  first  place  be 
directed  to  the  removal  of  all  extrinsic  causes ;  secondly,  to  pro- 
mote a  better  condition  of  the  system  generally ;  and  thirdly, 
to  modify  the  local  manifestations  of  the  disease. 

In  order  to  promote  a  better  tone  of  the  system,  attention 
must  be  paid  to  the  state  of  the  digestive  organs.  Diarrhoea 
may  be  present,  the  fseces  containing  clots  of  curdled  milk, 
mixed  with  much  mucus,  foetid  in  odour,  and  irritating  to  the 
anus ;  or  the  bowels  may  be  constipated.  In  both  conditions, 
a  very  gentle  laxative,  as  four  ounces  of  castor  oil,  with  two 
drams  of  the  bicarbohate  of  soda,  may  be  given ;  and  when 
the  bowels  are  restored  to  their  proper  state,  a  pint  of  lime 
water  in  a  little  milk  two  or  three  times  daily,  in  addition  to 
half-ounce  doses  of  the  syrup  of  the  compound  phosphates  or 
"  chemical  food"  twice  per  day.  I  can  speak  with  great  con- 
fidence of  the  phosphates  as  being  most  beneficial  in  all  debili- 
tating diseases  of  young  animals.  Great  care  must  be  taken  to 
see  that  the  patient  suckles  its  mother  sufficiently  often,  and 
if  he  be  unable  to  stand  to  do  so,  he  must  be  lifted  and  held  up. 
If  the  mother  has  not  sufficient  milk,  the  deficiency  must  be 
supplied  with  cow's  milk,  care  being  taken  that  this  does  not 
constipate  the  bowels ;  the  addition  of  a  small  quantity  of 
sugar  or  treacle  to  it  will  be  useful.  The  mother  must  rest 
from  work,  and  be  supplied  with  good  food ;  a  mixture  of  beans, 
oats,  bran,  and  grass  if  in  season,  will  be  most  suitable. 

The  lime  water  is  recommended  as  an  antacid.  At  one  time 
it  was  supposed  to  supply  lime  to  the  bones ;  it  is  now  held  that 
the  bone  diseases  of  the  young  are  not  due  to  the  want  of  lime, 
but  to  its  elimination  from  the  system  by  the  kidneys.  Autho- 
rities, however,  are  divided  upon  this  subject. 

The  Local  Treatment. — If  the  urachus  be  pervious,  the  patient 
is  to  be  cast,  and  a  suture  tied  round  the  umbilical  cord.  In 
performing  this  operation,  the  following  rules  ought  to  be 
remembered: — 1st.  No  rope  is  needed  to  throw  a  young  foal. 
2d.  The  suture  must  be  thick,  as  thick  as  the  cord  which  is  used 
for  window  blinds,  and  made  of  string  or  cord,  in  preference  to 
metallic  wire  or  caustic  clam,  for  the  following  reasons : — that 


164  DISEASES  OF  THE  BONES  AND  ARTICULATIONS. 

rapid  sloughing  of  the  portion  included  is  to  be  avoided ;  that 
the  adhesion  of  the  urachus  is  most  likely  to  be  produced  by 
firm  but  not  violent  pressure ;  and  that  the  thick  suture  is  less 
likely  to  cut  through  the  structures  which  it  encloses  than  a 
thinner  one,  or  suture  wire,  and  not  so  liable  to  irritate  and 
annoy,  by  its  weight  and  presence,  as  the  clam. 

The  application  of  the  suture  must  be  in  the  form  of  a  stitch, 
the  skin  being  pierced  by  the  needle  on  both  sides  of  the  urachus, 
and  the  suture  tied  round  it  as  a  loop.  "When  thus  applied, 
there  is  no  danger  of  its  slipping  off.  The  practitioner  must 
not  be  afraid  to  take  a  deep  hold,  and  enclose  plenty  of  skin 
in  the  suture,  in  order  that  the  adhesive  action  may  surround 
the  opening,  and  thus  be  a  future  support  to  the  more  tardy 
adhesive  action  of  the  mucous  lining. 

The  formation  of  healthy  lymph  within  the  urachus  will  be 
much  favoured  by  injecting,  before  the  suture  is  applied,  a 
solution  of  nitrate  of  silver,  ten  grains  to  the  ounce  of  water. 

If  the  parts  enclosed  in  the  suture  should  slough  off,  and  the 
flow  of  urine  return  whilst  the  patient  is  otherwise  improving, 
the  suture  may  be  again  applied ;  but  if  the  general  symptoms 
have  become  worse,  the  sufferer  should  be  destroyed,  as  the  non- 
union of  the  urachus  indicates  that  the  material  formed  in  and 
around  it  is  aplastic,  and  not  fitted  for  permanent  repair,  or  to 
be  converted  into  proper  tissue. 

In  conclusion,  it  must  be  always  remembered  that  the  health 
of  the  mother  plays  a  most  important  part  in  the  production  and 
removal  of  this  disease,  and  must  upon  all  occasions  demand  the 
veterinary  surgeon's  care  and  attention. 


CHAPTER  IX. 

DISEASES  OF  THE  BONES  AND  ARTICULATIONS — Continued. 

ULCERATION CARIES NECROSIS CENTRAL   AND   SUBPERIOSTEAL 

SUPPURATION ABSCESS   IN   THE   SUBSTANCE   OF   A  BONE. 

Writers  upon  human  surgery  make  a  distinction  betw.een 
ulceration  of  bone  and  caries,  both  conditions  being  associated 
with  the  formation  of  pus.  Thus,  Professor  Syme  says — "  By 
ulceration  we  mean  that  condition  of  bone  in  which  there  is 
loss  of  substance,  together  with  suppuration,  but  in  which  the 
ulcer  has  a  tendency  to  heal.  In  caries,  on  the  contrary,  while 
there  is  a  loss  of  substance,  together  with  suppuration,  there  is 
so  far  from  being  any  tendency  to  heal,  that  healing  is  very  diffi- 
cult to  accomplish."  The  same  authority,  quoting  from  Listen, 
says : — "  It  may  tend  to  prevent  confusion  of  the  two  morbid 
states,  if  we  confine  the  term  ulceration  to  suppuration  in  and 
absorption  of  bone,  whilst  the  vessels  retain  a  considerable 
power  of  action,  throw  out  new  matter,  and  procure  a  repara- 
tion of  the  breach;  and  this  condition  of  the  osseous  tissue 
exists  when  the  disease  is  situated  on  the  surface  of  the  bone, 
and  when  it  has  been  induced  by  an  external  cause.  On  the 
contrary,  the  term  caries  will  denote  that  particular  kind  of 
ulceration  in  which  reparation  is  hardly  attempted  by  nature, 
and  is  with  difficulty  obtained  by  the  most  active  influence, 
and  this  disease  will  be  most  generally  found  to  affect  the 
cancellated  structure. 

To  the  veterinary  pathologist  this  difference  is  not  at  all 
satisfactory,  and  it  may  be  laid  down  as  a  rule  that  ulceration 
of  bone  with  a  discharge  of  pus  is  the  result  of  external  injury — 
that,  in  fact,  there  is  necrosis,  or  actual  death  of  a  layer  of 


166  DISEASES  OF  THE  BONES  AND  ARTICULATIONS. 

bone,  more  or  less  deep,  as  the  case  may  be,  the  injury  being 
inflicted  upon  a  part  of  the  bone  other  than  its  articular  end ; 
whilst  caries  is  confined  to  the  extremities  of  the  loncj  bones 
and  cancellated  structure  of  the  short  and  irregular  bones ;  and 
when  not  caused  by  external  injury,  is  unaccompanied  by  the 
formation  of  pus.  Of  this  we  have  many  examples  in  navicular 
disease,  bone-spavin,  ring-bone,  &c. 

Professor  Spence  says,  that  "  The  peculiar  obstinacy  of  a 
truly  carious  surface  arises  from  the  fact  that  a  large  part  of  it 
is  really  dead."  This,  in  my  opinion,  is  necrosis,  and  when  the 
necrosis  occurs  in  our  patients,  it  is  always  accompanied  by  sup- 
puration. I  shall,  therefore,  distinguish  these  two  terminations 
of  ostitis,  when  not  caused  by  external  injury,  as — 1st.  Caries  or 
removal  of  degenerated  bone  tissue  by  absorption  without  sup- 
puration, commonly  found  to  exist  in  the  articular  ends  of  the 
bones;  and,  2d.  ^N'ecrosis,  or  death  of  a  bone,  or  a  portion  of 
bone,  accompanied  by  suppuration;  the  dead  bone  being  removed 
by  expulsion  or  surgical  interference. 

Caries  may  arise  from  traumatic  or  idiopathic  inflammation 
of  the  synovial  membrane,  or  from  ostitis  commencing  in  the 
cancellated  structure  of  the  bone,  and  it  may  be  defined  as  a 
slow  absorptive  process  by  which  the  bone  becomes  eroded  and 
cribriform  in  appearance,  the  absorption  extending  to  a  distance, 
the  bone  converted  into  a  brittle  mass,  and  the  surrounding 
parts  more  vascular  and  swollen  than  in  the  normal  state.  Or  the 
destructive  process  is  limited,  by  a  deposition  of  bony  material 
within  the  cancellated  structure  of  the  bone,  rendering  it  of  an 
ivory-like  appearance  when  cut  into,  and  increasing  its  density 
and  weight. — (See  Fig.  20,  page  152.) 

Caries  commences  in  the  interior  of  a  bone,  and  makes  its 
way  outwards;  the  bone  acquires  a  red  hue;  its  articular  sur- 
face becomes  soft;  its  laminal  layer  and  articular  cartilage  are 
removed,  exposing  the  cancellated  structure,  from  which  vascu- 
lar processes  shoot  out  in  the  form  of  red  teat-like  granulations; 
the  surface  of  the  opposing  bone — forming  the  articulation — 
becomes  similarly  diseased,  the  granulations  from  the  one  bone 
coalesce  with  those  from  the  other,  and  form  a  vascular  connec- 
tion between  the  interior  of  both  bones.  In  this  manner  the 
process  of  anchylosis  is  commenced. 

When  caries  is  situated  in  a  bone  over  which  a  tendon  plays. 


CARIES.  167 

as  the  navicular,  sesamoid,  or  bicipital  groove  of  the  humerus, 
the  fibres  of  the  tendon  become  "  ruptured  by  abrasion  "  upon  the 
roughened  surface,  or  by  an  inflammatory  softening — gelatina- 
tion — of  the  tendon,  whereby  its  smooth,  cartilaginous  surface 
becomes  roughened ;  string-like  processes  of  its  fibres  are  seen 
upon  it;  which  finally  unite  to  vascular  projections  from  the 
bone,  and  form  a  bond  of  union  between  the  two.  The  pro- 
gress of  caries  is  thus  arrested  by  the  adhesion  of  the  tendon 
to  the  bone. 

The  effect  of  caries  is  to  remove  the  bony  laminal  layer 
and  the  cartilage,  and  thus  destroy  the  articulation  which  it 
may  invade ;  but  whilst  this  process  of  destruction  goes  on 
within  the  bone  and  upon  its  extremity,  we  find  that  the  peri- 
osteal surface  and  compact  tissue  become  the  seat  of  new  bony 
deposit,  situated  beneath  the  periosteum,  which  envelops  the 
diseased  bone,  as  it  were,  in  a  ring,  and  extends  to  all  the 
bones  of  an  articulation  which  may  be  involved  in  the  caries ; 
finally,  binding  them  firmly  together;  in  fact,  converting  two  or 
more  bones  into  one,  and  destroying  motion.  The  united  bones 
now  perform  the  functions  of  one  bone ;  and  in  virtue  of  this 
the  pain  produced  by  the  attrition  of  the  roughened  surfaces 
of  the  bones  one  upon  the  other  is  no  longer  caused. 

Within  the  bone  the  degenerative  process^  in  the  majority  of 
cases  that  have  been  carefully  examined  by  me,  is  limited  by ; 
consolidation  of  the  cancelli ;  and  in  a  recent  specimen  which  I 
have  in  my  possession,  I  found  that  the  first  alteration  to  be  ■ 
observed,  in  addition  to  tlie  increased  vascularity,  was  the 
removal  of  the  fatty  material — which  is  found  abundantly  in 
bone  during  health — and  the  formation  of  an  organizable  lymph, 
which  is  finally  converted  into  bone,  giving  to  the  original 
trabeculated  structure  an  ivory-like  appearance. 

The  external  signs  of  caries  vary  according  to  its  seat.  If  it 
be  in  the  bones  of  an  articulation  having  a  distensible  capsular 
ligament,  as  the  true  hock,  there  will  be  swelling  of  the  joint  by 
distension  of  its  synovial  membrane  and  capsular  ligament,  with 
heat,  pain,  and  lameness.  But  if  it  be  limited  to  the  mere  gliding 
articulations,  their  synovial  membranes  are  too  limited  to  allow 
of  this  distension;  and  before  the  appearance  of  the  external 
subperiosteal  deposition  just  referred  to,  the  speciality  of  the 
lameness  and  heat  of  the  part  are  the  only  signs. 


168  DISEASES  OF  THE  BONES  AND  ARTICULATIONS. 

Treatment. — ^When  caries  is  firmly  established,  the  only 
method  by  which  it  can  be  repaired  is  by  assisting  the  process 
of  adhesion  between  the  opposing  surfaces.  This  is  to  be  effected 
by  rest ;  and  by  the  actual  cautery,  which  has  a  wonderful 
effect  in  allaying  the  diseased  action  and  removing  the  pain.  It 
also  promotes  the  formation  of  reparative  material,  and  hastens 
the  process  of  repair.  It  must  be  understood  that  when  anchy- 
losis occurs  in  articulations  with  extensive  motion,  such  as  the 
true  hock,  elbow,  &c.,  the  animal  is  of  little  use,  and  no  treat- 
ment is  of  any  avail ;  but  when  caries  is  commencing  in  these 
situations,  its  progress  may  be  arrested  by  rest  and  the  cautery, 
or  other  severe  external  irritant.  But  when  the  mere  gliding 
joints  are  its  seat,  then  anchylosis  may  be  looked  upon  as  a 
radical  cure. 

Necrosis,  or  death  of  a  bone,  corresponds  to  mortification  of 
the  soft  structures,  and  is  as  distinct  from  caries  as  mortification 
is  from  ulceration.  Necrosis  is  divided  into  four  varieties, 
namely,  \st,  the  scrofulous ;  2cl,  the  superficial,  or  that  which  in- 
volves the  outer  lamella,  and  presents  itself  in  the  flat  and  long 
bones ;  2>d,  that  form  which  destroys  the  internal  part  of  a  bone, 
and  in  which  the  outer  shell  is  not  affected ;  and  4dh,  that  in 
which  the  whole  thickness  of  the  bone  dies.  The  last  three 
forms  are  respectively  named  external,  superficialis  or  partialis, 
central  or  internal,  and  general  necrosis,  or  necrosis  totalis. 

Necrosis  superficialis  depends  upon  very  acute  superficial 
ostitis,  periostitis,  or  any  injury  which  destroys  the  periosteum, 
as  well  as  injuring  the  bone  itself.  It  was  thought  at  one  time 
that  the  mere  removal  of  the  periosteum  was  sufficient  to  pro- 
duce this  form  of  necrosis,  but  it  is  now  ascertained  that  such  is 
not  the  case,  and  that  when  necrosis  and  exfoliation  occur,  they 
do  so  from  the  violence  which  separated  the  periosteum  having 
destroyed  the  vitality  of  the  bone  itself. 

I  am  not  aware  that  this  form  occurs  except  from  direct 
violence  to  the  part,  such  as  blows,  kicks,  &c.,  which  expose  the 
surface  of  the  bone,  and  excite  inflammation  in  the  adjoining 
tissues.  The  necrosed  portion  presents  a  white,  waxy  appear- 
ance, as  if  it  had  been  carefully  macerated,  sonorous  when  struck 
by  a  probe,  and  if  exposed  to  the  atmosphere  before  separation, 
it  becomes  changed  in  colour,  passing  through  various  degrees  of 
green,  brown,  and  black.     These  changes  are  attributed  to  the 


NECROSIS.  169 

action  of  the  atmosphere  and  the  character  of  the  discharge. 
The  limits  of  the  dead  portion  are  not  always  easily  defined,  and 
at  all  times  its  outlines  are  very  irregular.  If  the  skin  should 
be  uncut,  or  be  healed,  over  the  seat  of  the  injury,  an  abscess 
soon  forms,  which,  if  left  alone,  discharges  itself;  and  if  the 
ulcer  is  examined  by  a  probe,  the  bone  will  be  found  bare,  and 
perhaps  loose.  The  abscess  does  not  heal  until  the  loose  por- 
tion, called  an  exfoliation,  is  removed ;  in  fact,  there  is  now  a 
fistulous  communication  between  the  dead  bone  and  the  at- 
mosphere. The  separation  of  the  dead  bone  is  effected  by 
the  absorption  of  the  layer  of  living  bone  immediately  con- 
tiguous to  it,  by  a  process  analogous  to  sloughing  of  the  soft 
parts. 

When  the  dead  bone  is  removed — naturally  or  by  surgical  in- 
terference— the  surface  beneath  it  gTanulates,  and  bony  matter 
is  formed  in  the  gap,  which,  however,  is  not  always  sufi&cient  to 
fill  it,  but  to  round  off  its  edges,  and  the  part  is  left  permanently 
deficient. 

Free  vent  must  be  given  to  the  pus,  which  is  curdy  in  con- 
sistence, and  foetid  in  odour — the  dead  bone  examined,  and  when 
found  to  be  loose  removed  by  the  forceps.  If  the  necrosed 
portion  be  a  mere  thin  pellicle,  the  dilute  hydrochloric  acid 
will  often  dissolve  it,  and  thus  save  a  prolonged  process  of  ex- 
foliation. 

This  form  of  necrosis  often  attacks  the  inferior  maxillary  bone 
from  the  pressure  of  the  curb,  and  the  os  pedis,  from  pressure 
of  a  foreign  body,  as  the  shoe  nail. 

Necrosis  totalis  affects  the  shafts  of  the  long  bones,  more 
especially  the  metacarpals  and  the  metatarsals,  and  also  the 
scapulae.  One  specimen  of  the  latter  is  now  in  the  Veterinary 
College  Museum. — (See  Photo-lithograph,  Plate  I.,  Fig.  6.) 
The  cause  of  this  form  is  violent  concussion,  as  from  galloping 
or  jumping,  producing  violent  ostitis,  which  from  its  rapidity 
does  not  permit  the  dense  texture  of  the  bone  to  open  out,  so 
as  to  allow  the  Haversian  canals  to  accommodate  the  congested 
vessels,  or  permit  them  to  relieve  themselves  sufficiently  by 
effusion.  In  addition  to  tliis,  the  small  amount  of  exudation 
which  ensues  blocks  up  the  canaliculi  and  lacunae  of  the  bone, 
arresting  its  nutrition,  and  finally  destroying  its  vitality. 

When  the  vitality  of  the  bone  is  destroyed,  a  large  deposit 


170 


DISEASES  OF  THE  BOXES  AND  ARTICULATIONS. 


of  osseous   matter  takes  place   under  the  periosteum,  and  in 

this  manner  the  dead  bone,  which  is 
called  a  sequestrum,  becomes  enclosed 
within  a  capsule,  perforated  by  numer^ 
ous  openings  termed  cloacoe  (see  Fig" 
25),  and  these  are  not  filled  up  until 
the  dead  bone  is  entirely  removed ;  but; 
after  this  has  taken  place,  granula^ 
tions  spring  up  from  the  inner  surface  of 
the  shell,  and  the  cavity  is  eventually 
filled  up  by  osseous  matter,  so  that  in- 
stead of  a  hollow  bone  we  find  a  solid 
cylinder. 

It  may  be  here  noticed  that  the  bones 


of  the  legs  of  race-horses  are  more  liable 
to  necrosis  than  those  of  animals  of  a 
coarser  breed,  not  only  because  they  are 
subjected  to  greater  concussion,  but  being 
more  compact  in  their  structure,  inflam- 
mation in  them  is  apt  to  terminate  in 
their  death. 

The  separation  of  the  sequestrum  is  de- 
scribed as  follows  by  Eokitansky  : — "  All 
round  the  necrosed  portion,  that  is  to 
say,  at  its  margins,  and  at  the  part  where 
its  surface  is  exposed  to  that  of  the  healthy 
Fig  25.— Necrosis  totalis  \)o^q  the  latter  undercroes  a  gradual  ex- 
questrai  capsule.  6  and  c,  pausion  or  rarefaction  of  its  tissue,  by 
Cloacae,  or  foramina  grandia.  ^he  enlargement  of  its  Haversian  canals, 
assumes  a  rosy  colour,  and  becomes  succulent.  It  gradually 
acquires  an  areolar  structure,  and  is  thus  more  rarefied ; 
at  length  it  disappears  altogether,  and  a  red,  soft,  spongy 
substance,  or  layer  of  granulations,  occupies  its  place.  This 
change  is  produced  by  the  inflammatory  process,  which  gives  rise 
to  suppuration  and  granulation ;  the  bony  tissue  beginning  with 
the  Haversian  canals  is  dissolved  by  the  matter  secreted  within 
them;  while  the  granulations  which  shoot  forth  at  the  same 
time  fill  up  the  enlarged  canals.  The  immediate  result  of  this 
process  is  the  formation  of  a  furrow  of  demarcation,  which  en- 
circles the  margin  of  the  dead  bone,  and  is  filled  up  with  granula- 


NECROSIS. 


171 


tions  ;  and  so  far  as  the  process  is  completed  on  that  surface,  of 
the  living  bone  which  faces  the  dead,  so  far  is  the  sequestrum 
separated."  The  necrosed  portion  is  very  irregular  in  its  outline, 
and  the  luxuriant  granulations  from  the 
living  parts  shoot  into  these  irregularities, 
causing  a  dove-tailing  closely  resembling 
actual  union.  From  various  specimens 
in  my  possession,  I  find  that  the  dead 
bone,  when  of  any  considerable  magni- 
tude, is  removed  in  numerous  portions, 
that  is  to  say,  it  becomes  broken  into 
several  fragments,  whicli  find  their  way 
to  the  surface  through  the  cloacse  time 
after  time.  In  the  annexed  illustra- 
tion five  sequestra  were  found  within  the 
capsule. 

The  cloacae,  or  foramina  grandia,  serv- 
ing as  outlets  for  the  pus  and  sequestra, 
present  themselves  about  the  middle  or 
lower  third  of  the  new  bone  as  oval- 
shaped  openings  ;  and  a  remarkable  fact 
has  been  pointed  out  by  Professor  Good- 
sir,  connected  with  these,  namely,  that 
"  they  are  almost  invariably  opposite  to  a 
smooth  or  unaltered  surface  of  the  dead 
shaft,  and  that  they  result  from  the  pus, 
thrown  out  from  the  granulating  internal 
surface  of  the  new  shaft,  making  its  way 

.        .1  ,      .  1.1  .  i.         ^       I'iG.   26.— Section  of  the 

to    the    exterior,    by    the     parts    not    yet  bone  represented  in  Fig.  25, 

closed,  in   consequence    of  having   been  showing  five  sequestra,  or 

.,  , .  „    .,         1  1     1     n^        1  .   1     dead  pieces  of  the  original 

opposite   portions    Ot   the  old  shaft,  which  bone.      a,  Capsule;  6  and  c, 

had  not  afforded  separate  osseous  centres."  Sequestra. 
By  this,  Goodsir  means  that  the  smooth  surface  of  that  part  of 
the  old  shaft  had  not  afforded  spiculas  of  bone  adherent  to  the 
periosteum,  when  that  membrane  became  separated  from  the 
old  shaft,  to  act  as  centres  of  ossification  ;  for  he  founded  the 
doctrine  that  the  formation  of  new  bone  depended  not  so  much 
on  the  periosteum,  as  upon  the  spiculae  of  living  bone  which 
were  attached  to  it.  He  says  : — "  When  the  entire  shaft  of  a 
bone  is  attacked  with  violent  inflammation,  there  is  generally 


172      DISEASES  OF  THE  BONES  AND  AKTICULATIONS. 

time,  before  tlie  death  of  the  bone  takes  place,  for  the  separa- 
tion of  more  or  less  numerous  portions  of  its  surface.  When 
the  entire  periosteum  has  separated  from  the  shaft,  it  carries 
with  it  minute  portions  of  the  surface  of  the  bone.  Each  of 
these  is  covered  on  its  external  surface  by  the  periosteum,  on 
its  internal  by  a  layer  of  granulations,  the  result  of  the 
organized  matter  which  originally  filled  the  Haversian  canals ; 
the  gradual  enlargement  and  subsequent  blending  of  which 
ultimately  allowed  their  vascular  contents  to  combine,  with  the 
layer  of  granulations  just  described,  to  form  the  separating 
medium  between  the  dead  shaft  and  its  minute  living  remnants. 
These  minute  separated  portions,  after  having  advanced  some- 
what in  development,  appear,  when  carelessly  examined,  particu- 
larly in  dried  specimens,  to  be  situated  in  the  substance  of  the 
periosteum,  and  have  been  adduced,  by  the  advocates  of  the 
agency  of  that  membrane  in  forming  new  bone,  as  evidences  of 
the  truth  of  their  opinions." 

The  causes  of  necrosis  totalis  are  ostitis  and  periostitis  of  a 
violent  form,  brought  about  by  galloping,  jumping,  or  any  other 
cause  of  violent  concussion ;  it  is  situated  in  the  long  bones, 
or  in  the  os  pedis  in  some  cases  of  very  acute  laminitis,  with 
sloughing  ;  and  a  partial  or  total  necrosis  of  this  bone  sometimes 
results  after  neurotomy. 

The  symptoms  are  violent  pains,  manifested  by  lameness,  if 
in  the  extremities,  with  swelling,  at  first  doughy  and  elastic, 
by  reason  of  the  effusion  between  the  periosteum  and  bone, 
and  of  the  thickening  of  the  periosteum  itself;  it  presents  no 
distinct  boundary  when  involving  the  whole  length  of  the  shaft. 
The  swelling  gradually  becomes  harder  as  the  process  of  ossifi- 
cation goes  on ;  but  at  various  parts,  more  especially  towards 
the  lower  portion  of  the  bone,  soft  points  can  be  detected  in  it, 
attended  eventually  by  fluctuation.  These  finally  burst,  and 
discharge  pus,  which  may  at  first  be  odourless ;  but  after  the 
abscesses  have  been  open  a  short  time,  it  emits  that  peculiar 
fcetor  characteristic  of  diseased  or  dead  bone.  If  the  abscesses 
be  examined  with  the  probe,  the  bone  will  be  found  bare,  and 
perhaps  loose. 

Treatment. — If  a  considerable  length  of  a  shaft  is  dead,  some 
time  must  be  allowed  for  the  consohdaticm  of  the  capsule  before 
any  attempt  is  made  for  the  removal  of  the  sequestrum,  taking 


NECROSIS.  173 

care  that  the  animal  is  properly  cared  for,  by  having  good  food, 
comfort,  and  cleanliness ;  but  if  the  bone  be  not  a  weight-bearing 
one,  as  the  inferior  maxilla,  no  time  should  be  lost  in  removing 
all  portions  of  the  dead  bone.  The  following  case  will  illustrate 
the  necessary  treatment. 

A  bay  mare  was  brought  to  the  College  last  winter  with  a 
fistulous  opening  in  the  lower  jaw,  from  which  flowed  a  large 
quantity  of  very  foetid  pus.  Upon  examination,  about  five 
inches  of  the  original  bone,  extending  from  the  incisors  back- 
wards, was  found  enclosed  in  a  capsule  of  new  bone,  in  which 
were  several  cloacse  connected  with  the  fistula.  Wlien  the 
probe  was  introduced,  loose  pieces  of  bone  could  be  detected 
within  the  capsule.  The  animal  was  cast,  the  skin  dissected 
from  the  largest  fistula,  and  the  cloacae  enlarged  with  the  tre- 
phine. It  was  found  necessary  to  make  two  openings  in  the 
capsule,  before  the  sequestrse  could  be  removed  by  the  forceps ; 
the  parts  were  now  washed  out  by  syringing  with  dilute  carbolic 
acid  (the  fcetor  being  very  offensive),  and  the  animal  allowed  to 
rise.  Three  days  afterwards  the  discharge  had  entirely  ceased ; 
the  wound  healed  up  rapidly,  and  the  mare  continues  well  to 
this  day. 

The  same  principle  of  treatment  will  apply  to  necrosis,  wher- 
ever situated,  care  always  being  taken  that  every  portion  is 
removed,  and  that  strong  and  proper  instruments  are  used. 
The  symptoms  of  partial  necrosis  of  the  os  pedis  will  be  exactly 
like  those  of  partial  fracture  of  it  (described  hereafter) ;  and 
the  symptoms  of  total  necrosis  in  acute  laminitis  will  be  swell- 
ing round  the  coronet,  with  great  lameness,  separation  of  the 
crust  from  the  sensitive  foot,  discharge  of  a  dark-coloured 
sanious  matter  from  the  upper  part  of  the  foot,  and  finally,  if 
the  animal  live,  sloughing  of  the  whole  hoof,  accompanied  by 
great  constitutional  excitement  and  irritative  fever;  the  pulse, 
at  first  hard,  full,  and  rapid,  finally  becomes  small,  thready,  and 
quick ;  with  fcetor  of  the  breath  in  some  cases,  and  death  in  a 
very  short  space  of  time.  The  fcetor  of  the  breath  and  the  very 
rapid  sinking  are  supposed  to  be  caused  by  absorption  of  the 
sanious  discharge. 

I  think  I  need  scarcely  remind  the  reader  that  in  compound 
fractures,  when  the  fragments  are  completely  detached  and 
separated  from  the  bone,  they  die,  constituting  necrosis  by 


174      DISEASES  OF  THE  BONES  AND  ARTICULATIONS. 

fracture;  that  in  all  cases  their  presence  is  made  manifest  by 
the  formation  of  fistulous  abscesses ;  and  that  their  removal  is 
imperative. 

In  the  ox  tribe,  the  digital  bones  suffer  from  necrosis,  owing 
to  an  inflammation  of  the  inter-digital  fibrous  tissue. 

It  was  supposed  at  one  time  that  a  sequestrum  was  reduced  in 
size  by  the  action  of  the  absorbents ;  but  it  is  now  placed  beyond 
all  doubt  that  dead  bone  is  in  every  respect  a  foreign  body,  and 
cannot  be  acted  upon  by  the  absorbents  more  than  any  other 
insoluble  substance.  But  at  the  same  time  it  must  be  admitted 
that  a  sequestrum  is  much  smaller  than  the  original  bone ;  this 
can  only  be  accounted  for  by  the  fact  that  its  animal  basis  is 
dissolved  by  the  purulent  discharge,  and  that  it  is  thus  rendered 
brittle,  and  liable  to  be  broken  into  fragments  by  the  movements 
of  the  animal. 

Internal  necrosis  is  very  rare  in  the  lower  animals,  one  speci- 
men only  in  the  Museum  presenting  any  appearance  of  it.  The 
following  are  its  symptoms  in  the  human  being,  namely,  most 
excruciating  pains,  supposed  to  arise  from  the  resistance  of  the 
outer  sheU  to  the  sw^elling  of  the  inflamed  part.  The  fever  is 
often  so  high  as  to  prevent  the  patient  obtaining  repose.  The 
enlargement,  exceedingly  hard  and  diffuse,  depends  on  the  swollen 
condition  of  the  bone,  and  in  time  becomes  very  vascular  and 
softened.  The  medullary  membrane  is  completely  destroyed. 
The  swelling  continues  for  a  long  time,  but  abscesses  gradually 
form  in  the  soft  parts ;  the  outer  layer  of  the  old  bone  expands 
and  grows,  during  the  continuance  of  the  suppuration,  by  the 
dilation  of  the  Haversian  canals;  whilst  new  bone  is  formed 
externally,  so  that  the  sequestral  capsule  is  partly  of  old  bone 
and  partly  of  new.  "When  the  sequestrum  is  removed,  and  the 
process  of  regeneration  complete,  the  bone  consists  from  without 
inw^ards  of  the  outer  shell  of  new  bone,  the  layer  of  old  bone 
which  is  not  necrosed,  and  the  central  portion  of  new  bone 
formed  by  the  granulations  within,  and  which  for  a  long  time 
occupies  the  place  of  the  medullary  canal. 

The  interior  of  the  bone,  at  first  solid,  becomes  opened  up  by 
the  gradual  enlargement  of  the  Haversian  canals  of  the  new 
bone,  whereby  its  structure  becomes  cellular,  and  in  this  way  it 
incompletely  supplies  the  place  of  the  medullary  canal. 

Many  experiments  have   been   made  which   show  that  the 


NECROSIS.  175 

destruction  of  the  medulla  is  sufficient  to  cause  tlie  death  of  a 
bone,  and  it  has  also  been  carefully  noted  that  the  power  of 
reproduction  varies  in  the  different  bones  of  the  body,  being 
great  in  some,  and  less  in  others,  and  in  some  absent  altogether. 
Thus  the  long  bones,  the  lower  jaw,  and  scapula  possess  the 
power  of  reproduction  to  a  great  extent ;  the  cuboid  and  other 
short  bones  cannot  be  reproduced. 

Portions  of  the  cranium,  under  particular  circumstances,  says 
Pirrie,  may  to  a  certain  extent  be  reproduced;  but  if  both 
tables  be  destroyed,  together  with  the  pericranium,  there  will 
be  very  slight  reproduction ;  for  the  dura  mater  has  very  little 
tendency  to  produce  new  bone,  and  for  this  reason  reproduction 
does  not  take  place  after  the  operation  of  trephining  the  skull. 
The  bones  of  the  face,  however,  seem  to  have  the  property,  for 
in  several  instances  I  have  witnessed  complete  reproduction  after 
trephining  the  maxillary  sinuses. 


SUBPERIOSTEAL  SUPPURATION. 

Suppuration  beneath  the  periosteum  is  not  uncommon,  and 
may  result  from  blows,  such  as  "  speedy-cut,"  or  from  such  opera- 
tions as  "  punching "  for  bone-spavin.  The  symptoms  of  this 
form  of  suppuration  are,  diffuse  swelling,  extending  in  every 
direction  from  the  seat  of  injury.  The  swelling  is  tense  and 
drum-like  when  felt ;  it  may  be  large,  whilst  it  contains 
but  little  pus ;  after  a  time,  however,  abscesses  form  on  various 
parts  of  it,  and  discharge  a  foetid  pus.  The  animal  is  very 
lame,  and  a  high  state  of  irritative  fever  supervenes,  which 
may  run  on  to  a  fatal  termination.  The  treatment  for  cases  of 
subperiosteal  suppuration  must  be  prompt,  and  should  consist 
in  making  free  incisions  through- the  periosteum,  and  thus  give 
vent  to  the  pus. 

Punctured  wounds,  more  especially  in  the  neighbourhood  of 
the  elbow-joint,  are  very  apt  to  be  complicated  by  a  collection 
of  pus  under  the  periostum,  which,  if  not  allowed  to  escape  by 
free  incision,  is  apt  to  burrow  upwards  into  the  articulation, 
thus  causing  that  dreaded  complication,  open  joint.  I  have 
seen  wounds  that  were  several  inches  from  the  articulation 
terminate  in  this  way. 


176 


DISEASES  OF  THE  BONES  AND  AETICULATIONS. 


ABSCESS  IN  THE  SUBSTANCE  OF  A  BONE. 

The  formation  of  abscess  in  the  substance  of  a  bone  is  of  rare 
occurrence,  and  I  have  only  witnessed  one  marked  case  of  it. 
The  bone  is  now  in  my  possession,  and  the  two  figures  represent 
its  external  and  internal  appearances. 


Fig.  27.  Fig.  28. 

Fig.  27. — External  view  of  humerus  of  a  horse,  with  central  abscess. 

Fig.  28. — Internal  view  of  same  bone.  At  a  is  a  well-defined  abscess, 
containing  inspissated  pus  ;  h  shows  the  dilated  condition  of  the  medul- 
lary canal,  the  cavity  being  originally  filled  with  pus. 

An  abscess  may  form  within  the  cancellated  structure,  which 
is  hollowed  out,  as  in  the  illustration,  and  is  generally  situated 
near  the  articular  extremity  of  a  long  bone.  The  same  amount 
of  inflammation  necessary  to  produce  pus  in  the  cancelli,  would, 
if  situated  in  the  compact  tissue,  cause  necrosis.  It  is  accom- 
panied by  thickening  of  the  outer  shell  of  the  bone,  as  in 
necrosis.  The  diagnosis  of  internal  abscess  will  be  very  diffi- 
cult, on  account  of  the  depth  of  its  seat.  The  enlarged  bone, 
with  pain,  will  be  our  only  guides  until  the  pus  has  pierced 


ABSCESS  IN  BONES.  177 

tlie  bone,  and  found  its  way  to  the  surface  of  the  skin. 
In  long-continued  cases  of  lameness,  with  enlargement  of  a 
bone,  as  in  the  specimen,  the  practitioner  should  open  the 
enlarged  portion  by  the  trephine,  the  probabilities  being  that 
he  will  find  either  pus,  or  a  sequestrum,  or  both,  imprisoned, 
and  that  their  removal  will  bring  on  a  favourable  termina- 
tion. In  the  case  from  which  the  specimen  was  obtained,  no 
other  reason  could  be  given  for  the  abscess  than  that  the  pole 
of  the  carriage,  by  continually  striking  this  part,  brought  on 
inflammation  and  suppuration  of  the  medullary  membrane,  as 
well  as  periostitis. 

When  the  trephine  has  to  be  used,  it  is  nearly  always  neces- 
sary to  cast  the  patient ;  making  a  careful  incision  on  to  the 
diseased  bone ;  avoiding  injury  to  important  blood-vessels  and 
nerves ;  dividing  the  muscular  structures  in  the  direction  of 
their  long  axes ;  separating  all  the  soft  tissues  from  the  bone 
before  the  trephine  is  applied,  or  its  teeth  will  become  clogged ; 
and,  finally,  washing  out  the  abscess  thoroughly  with  water  in 
which  a  small  quantity  of  the  pure  carbolic  acid  has  been  dis- 
solved; and  leaving  the  lower  portion  of  the  wound  in  the  soft 
structures  open,  to  allow  the  escape  of  the  discharges. 

Mr.  Stanley  says  that  "circumscribed  abscess  is,  in  some 
cases,  attributable  to  the  softening  of  tubercular  matter,  analo- 
gous to  a  pulmonary  vomica,  and  that  the  contents  may  be 
discharged,  leaving  a  cavity  resembling  a  tuberculous  cavity  in 
the  lungs."  The  circumscribed  abscess,  according  to  the  same 
writer,  "  usually  remains  of  a  small  size,  but  in  some  cases  it 
has  enlarged  much  beyond  the  natural  limits  of  the  bone. 
Such  an  enlargement  is  not  the  effect  of  a  simple  expansion 
of  the  walls  of  the  bone ;  for  in  some  of  these  cases  the  osseous 
walls  of  the  abscess  have  increased  in  thickness,  with  enlarge- 
ment of  the  cavity.  The  process  consists  of  the  combined 
action  of  absorption  on  the  inside  of  the  abscess,  and  of  osseous 
deposit  on  its  outside,  whereby  its  osseous  walls  may  acquire 
any  degree  of  thickness,  according  to  the  predominance  oi 
absorption  in  the  one  direction,  or  of  deposit  in  the  other." 


CHAPTER  X. 

KON-INFLAMMATORY  DISEASES  OF  BONES. 

RICKETS — MOLLITIES   OSSIUM — OSTEO-POROSIS — FRAGILITUS    OSSIUM- 
OSTEO-SARCOMA — EFFECTS  OF  MERCURIAL  POISONING  ON  BONES. 


EICKETS. 

The  terms  "  rickets "  and  "  racliitis  "  are  used  to  denote  an 
unnatural  softness  of  the  osseous  system  in  young  animals, 
and  is  referable  to  disordered  nutrition  of  tlie  osseous  tissue; 
in  fact,  to  the  mal-assimilation  and  non- development  of  the 

materials  neces- 
sary to  the  forma- 
tion of  bone. 

Rickets  may  be 
witnessed  in  foals, 
calves,  and  young 
dogs,  more  especi- 
ally young  spaniels 
and  pointers.  In 
foals  and  calves  the 
metacarpal  bones 
are  those  which 
soonest  bend;  in 
dogs,  the  lower 
third  of  the  hume- 
rus ;  giving  to  the 
dog  a  dwarf-like 
appearance  :  he 
stands    with    his 


Fig.  29. 


fore  legs  wide  apart,  and  walks  with  a  peculiar  rolling  gait, 
throwing  the  w^eight  of  his  body  from  one  limb  to  another  in 


RICKETS. 


179 


the   ground   with 
the    affected 


a  peculiarly  ludicrous  manner,  the  sternum  almost  touching  the 
ground.  In  foals  and  calves,  the  shafts  of  the  metacarpals  are 
the  first  to  give  way,  the  curvatures  being  from  within  out- 
wards; thus  the  knees  are  thrown  outwards,  and  the  toes 
drawn  inwards.  At  the  same  time,  the  articulations  and  ex- 
tremities of  the  bones  become  enlarged,  hot,  and  painful ;  caus- 
ing so  much  lameness  that 
the  little  animal  merely 
touches 
the  toes  of 
limbs. 

When  the  bones  of  the 
posterior  extremities  are 
affected,  the  toes  are  turned 
outwards,  the  hocks  in- 
wards ;  the  points  of  the 
calci  almost  touching  each 
other;  the  animal  being 
what  is  termed  "  cow- 
hocked,"  the  metatarsals 
at  their  middle  being 
bent  inwards  and  rather 
backwards.        Writers    on 

human     surgery     say    the 
Figs  29  and  30  illustrate  the  bent  condition   ^^^^^     ^^^     ^^^^     laterally 
of  the  humerus  m  rickety  dogs.  ^  -^ 

by  the  action  of  the 
muscles,  and  in  such  cases  they  are  always  bent  to  the  side 
on  which  the  muscles  act  most  powerfully.  This  holds 
good  in  the  case  of  the  humeri  of  dogs,  wherein  it  will 
be  found  that  the  inferior  extremities  of  those  bones  are  pulled 
upwards  and  outwards — as  in  specimens  29  and  30 — and 
the  lower  third  of  the  shafts  curved  inwards,  the  curvatures 
being  so  great  as  almost  to  bend  the  bones  completely  upon 
themselves. 

In  rickets,  not  only  is  there  a  deficiency  of  the  inorganic 
elements  of  the  bones  originally — namely,  the  phosphate  and 
carbonate  of  lime — but  there  is  a  want  of  power  to  assimilate 
these  salts ;  for  during  the  progress  of  the  disease  there  is 
inordinate  excretion  of  them  from  the  system,  as  shown  by 
deposits   in   the   urine.      The  structure  of  the   bones  is   soft, 


Fig.  30. 


180  NON-INFLAMMATORY  DISEASES  OF  BONES. 

cartilaginous,  and  open;  but  if  the  animal  be  allowed  to 
live,  earthy  matter  is  deposited  in  the  bones,  which  eventually 
become  firm ;  the  curvatures,  however,  remain.  It  is  a  notice- 
able fact  that  the  centre  of  the  curve  in  a  rickety  bone  becomes 
strengthened  by  a  deposition  of  additional  bony  matter ;  thus 
we  always  see  that  a  horse  with  bent  legs  has  depositions  in 
the  very  centre  of  the  arch,  strengthening  the  weakest  part,  and 
making  the  bones  bulkier  than  natural. 

In  hydrocephalus,  the  rickety  condition  of  the  bones  is  the 
result  of  the  pressure  of  the  cranial  fluid. 

Eickets  appears  when  the  patient  is  a  few  weeks  or  months 
old,  and  is  caused  by  constitutional  debility,  the  scrofulous 
diathesis,  or  by  external  and  preventible  causes.  Thus  we  find 
it  in  calves  which  are  not  allowed  to  suckle  their  mothers ;  in 
foals,  when  the  mothers  are  taken  to  work  during  the  day,  and 
their  offspring  allowed  to  suckle  perhaps  every  morning  and 
night,  or  at  most  three  times  a  day. 

In  all  cases,  there  is  a  tendency  to  irregularity  in  the  bowels, 
the  milk  passing  through  them  in  an  ill-digested,  curdy  condi- 
tion, white  in  colour,  and  sour  in  odour,  "  the  white  skit,"  as  it 
is  vulgarly  called.  In  a  high-bred  calf  that  I  once  observed, 
this  kind  of  purging  had  existed  for  several  weeks.  At  the 
time  I  saw  him  he  was  about  three  months  old ;  had  remained 
healthy  until  he  was  six  weeks  old,  at  which  time  he  manifested 
symptoms  of  rickets  ;  and  when  examined  by  me,  was  found  to 
have  bending  of  the  bones  of  the  extremities,  enlargement  of  the 
cranium,  with  separation  of  the  bones  at  their  sutures,  and  that 
he  was  blind  from  the  pressure  of  the  fluid  contained  within  the 
cranial  cavity. 

Professor  Dick  used  to  mention  in  his  lectures  the  case  of  a 
thorough-bred  horse  which  was  affected  with  rickets  when  a  few 
months  old.  He  afterwards  recovered,  and  out  of  compliment 
was  called  "  Tlie  Professor." 

The  treatment  of  rickets  must  be  directed  to  the  removal  of 
all  influences  deleterious  to  the  constitution ;  and  to  the  support 
of  the  weak  and  bent  limbs.  To  fulfil  the  first  purpose,  the  most 
appropriate  remedies  are  dry  and  pure  air ;  a  large,  roomy,  loose 
box,  or,  if  the  weather  be  w^arm  and  dry,  a  nice  field  or  paddock, 
and  the  constant  companionship  of  the  mother.  If  the  patient 
be  a  calf  which  has  not  been  allowed  to  suckle  from  its  birth. 


RICKETS.  181 

great  care  must  be  taken  that  it  be  fed  repeatedly,  thougli  mode- 
rately, during  the  day. 

The  constitutional  treatment  must  be  directed  to  the  con- 
dition of  the  digestive  apparatus.  A  very  gentle  aperient 
might  at  first  be  given  with  advantage,  such  as  four  ounces  of 
castor  oil — or  a  dose  corresponding  to  the  age  of  the  patient — 
made  into  an  emulsion,  with  two  drachms  of  the  bicarbonate  of 
potash  or  soda,  and  a  sufficiency  of  water.  This  should  be 
succeeded  by  small  quantities  of  lime-water,  say  half  a  pint, 
two  or  three  times  a  day,  in  the  same  quantity  of  milk ;  and 
when  the  acid  condition  of  the  bowels  has  passed  away,  w^hich 
will  be  indicated  by  absence  of  the  sour  or  acid  smell  and 
better  colour  of  the  fseces,  the  preparations  of  iron  will  be  found 
of  great  service,  more  especially  the  syi'up  of  the  phosphates, 
great  care  being  taken  that  the  digestive  organs  are  not  again 
thrown  out  of  order.  As  a  rule,  the  mother  possesses  an  abun- 
dant quantity  of  milk ;  but  should  it  be  otherwise,  the  patient's 
food  must  be  made  sufficient  for  its  wants  by  an  additional 
supply  of  milk  or  of  linseed  tea, — a  very  good  substitute,  and 
often  a  desirable  variety.  Cod-liver  oil  may  be  given  with 
advantage ;  and  if  the  animal  be  valuable,  the  expense  will  be 
amply  repaid  by  a  successful  issue. 

The  curvatures  in  the  limbs  are  to  be  supported  by  slight 
but  firm  splints  of  wood,  applied  to  the  concave  aspect  of  the 
curves,  taking  care  that  they  are  of  sufficient  length  to  reach 
the  unbent  portions  of  the  limbs,  both  above  and  below  the 
curves.  A  moderately  firm  bandage  round  both  splint  and  leg 
will  cause  the  latter  to  approach  the  straight  line,  the  bones 
at  this  age  being  elastic  and  pliable.  The  splints  must  be  so 
padded  as  not  to  bruise  the  prominent  parts  of  the  legs,  and 
when  properly  and  skilfully  applied,  may  remain  on  for  some 
weeks.  If  there  be  much  pain  and  lameness,  fomentations  and 
frictions  must  be  repeatedly  made  use  of,  and  the  splints  removed 
from  time  to  time. 

The  pathological  anatomy  of  rachitis  is  thus  given  by 
Eokitansky : — "  The  texture  of  the  bones  is  affected  in  two 
ways,  of  which  sometimes  one  predominates,  sometimes  the 
other.  In  the  first  case  the  bone  is  rarefied  and  increased  in 
size — expanded,  in  fact.  A  pale  yellowish-red  jelly  is  effused 
into  its  enlarged  canals  and  cells,  into  the  medullary  cavities, 


182  NON-INFLAMMATORY  DISEASES  OF  BONES. 

and  even  under  the  periosteum.  The  bone  itself  is  abundantly 
supplied  with  vessels,  and  full  of  blood,  and  its  colour  is  there- 
fore darker  than  is  natural,  and  red.  Occasionally  this  change 
reaches  to  such  a  degree  that  the  cells  of  the  spongy  bones, 
and  those  in  the  interior  of  the  medullary  tubes,  become  ex- 
cessively distended,  and,  as  their  walls  disappear,  are  merged 
into  larger  cavities ;  several  cavities  become  single  spacious 
chambers,  and  the  bones  uncommonly  soft  and  fragile.  In  the 
second  case  the  bone  is,  in  addition,  deprived  of  more  or  less 
of  its  mineral  constituents;  and  sometimes  it  is  completely 
reduced  to  its  cartilaginous  element,  and  appears  like  a  bone 
that  has  been  steeped  in  acid.  The  bony  corpuscles  are  empty, 
and  their  rays  have  disappeared  ;  and  when  this  is  the  case,  the 
lamellar  structure  is  here  and  there  obliterated.  At  other  parts 
the  laniellae  appear,  as  it  were,  to  have  fallen  asunder,  and  the 
corpuscles  are  seen  quite  distinctly  interspersed  between  them. 
It  is  upon  this  condition  that  the  flexibility  of  rickety  bones 
depends."  "  It  is  remarkable,"  says  Eokitansky,  "  that  in  cases  of 
general  rickets  the  reduction  of  a  bone  to  its  cartilaginous 
element  so  preponderates  in  some  bones  as  to  go  on,  even  to 
completion,  without  any  trace  of  rarefaction." 

The  late  Professor  Barlow  taught  that  in  rickets  the  car- 
tilage yielded  neither  chondrine  nor  gelatine.  This  theory 
was  based  upon  one  given  in  Simon's  Animal  Chemistry. 
However,  it  is  now  ascertained  that  the  analysed  bones  were 
not  rickety,  but  affected  by  mollities  ossium. 

To  conclude  the  subject  of  rickets,  I  must  say  that  the 
swelling  of  the  articulations  seems  to  indicate  that  the  disease 
does  not  consist  in  simple  absence  of  the  due  quantity  of 
phosphate  of  lime,  and  analysis  has  proved  that  the  cartilage 
itself  is  altered  in  its  constitution,  the  fat  increased,  and  the 
fluoride  of  calcium,  present  in  healthy  bone,  is  absent  in  rickets. 
Analyses  of  some  rickety  bones  give — animal  matter  81-12, 
earthy  matter  18-88  in  100  parts;  against  animal  matter  31-10, 
earthy  matter  68-90  in  healthy  bones. 

Allied  to  rickets  is  what  I  may  describe  as  true  atrophy  of 
the  bones,  or 

MOLLITIES  OSSIUM, 

A  remarkable   case    of  which   I   have  had   the    opportunity 


MOLLITIES  OSSIUM.  183 

of  seeing,  and  in  wliicli  there  was  removal  of  the  earthy- 
constituents  of  the  cranial  and  facial  bones,  more  especially 
at  their  borders,  without  any  visible  external  alteration  of 
structure.  There  was  neither  swelling  nor  abscesses;  in 
fact,  nothing  to  indicate  the  pathological  change.  In  this 
case  examination  after  death  revealed  softening,  thinning,  and 
perforation  at  the  sutures  and  in  the  bodies  of  the  bones,  giving 
them  a  pitted  and  worm-eaten  appearance.  The  perforations 
were  filled,  upon  the  cranium,  by  the  pericranium  and  dura 
mater,  which  were  adherent  to  one  another.  The  palatine  bones 
and  alveolar  processes  were  soft,  porous,  and  spongy. — (See 
Photo-lithograph,  Plate  I.,  Fig.  8.)  An  examination  of  the 
plate  will  show  that  the  borders  of  the  various  bones  are 
separated,  in  some  places,  to  the  extent  of  nearly  half  an  inch. 
The  ethmoidal  bone  was  completely  absorbed,  and  the  brain  lodged 
in  the  frontal  sinuses,  filling  them,  as  well  as  its  proper  cavity. 

The  case  is  so  interesting,  instructive,  and  unique,  that  I 
cannot  do  better  than  describe  it.  The  patient  was  a  grey 
Clydesdale  gelding,  nine  years  old.  He  had  always  been  in 
good  health  until  within  about  three  months  of  the  time  when 
I  saw  him.  At  this  time  he  was  suffering  from  the  effects 
of  delirium — the  third  attack  within  three  months — and  now, 
having  a  discharge  from  the  nostril,  was  supposed  to  be  glandered. 
I  found  him  blind  (amaurotic),  but  not  quite  unconscious ;  was 
very  somnolent,  or  semi-comatose ;  but  would  wake  up  with  a 
frightened  start  when  anything  disturbed  him.  He  was  in  fair 
condition;  the  nasal  discharge  was  of  the  nature  of  a  thin 
reddish  serosity,  and  more  abundant  from  one  nostril  than  from 
the  other.  He  was  unable  to  masticate  hay  and  corn,  or  did  so 
very  imperfectly,  and  was  becoming  worse  in  this  respect.  His 
powers  of  deglutition  were  also  imperfect,  and  on  examination 
I  found  the  teeth  were  loose,  and  that  he  could  not  close  his 
mouth  firmly ;  but  the  lips  were  not  pendulous.  Upon  inquiry, 
I  found  that  he  had  been  supported  by  thick  gruel,  oatmeal 
balls  forced  into  his  mouth,  bread  and  milk,  boiled  potatoes,  &c. 
In  fact,  being  a  great  favourite,  he  had  been  well  taken  care  of. 

Being  anxious  to  know  the  source  of  the  nasal  discharge, 
about  which  my  opinion  was  sought  by  the  attending  prac- 
titioner, I  explored  the  facial  sinuses  by  means  of  a  gimlet, 
and  discovered  that  the  bones  were  soft,  thin,  and  easily  perfo- 
rated, and  that  the  sinuses  were  not  filled  with  the  red  serosity 


184  NON-INFLAMMATORY  DISEASES  OF  BONES. 

above  mentioned.  Externally,  there  was  nothing  to  denote 
this  alteration  in  the  bones,  and  the  only  observable  change  of 
structure  was  wasting  of  the  masseter  muscles,  and,  as  a  con- 
sequence, an  apparent  undue  prominence  of  the  zygomatic 
ridge.  My  prognosis  was  unfavourable,  and  in  a  few  days 
afterwards  he  died  comatose.  On  making  an  examination,  the 
brain  was  found  very  white,  and  greatly  enlarged,  the  enlarge- 
ment partaking  of  the  character  of  a  fibrous  development ;  the 
dura  mater  was  much  thickened,  in  some  places  upwards  of 
an  inch  in  thickness.  The  lateral  ventricles  were  nearly 
obliterated  by  growth  of  fibrous  tissue  in  the  brain  substance. 
The  cranial  nerves,  with  the  exception  of  the  fifth  pair,  were 
normal  in  appearance;  but  this  (the  fifth)  pair  were  greatly 
enlarged,  not  only  in  their  general  bulk,  but  in  each  of  their 
fibres,  which  were  coarse,  stringy,  and  distinctly  separated  by 
an  abundance  of  fibrous  tissue.  As  already  stated,  the  eth- 
moidal bone  was  absorbed,  and  the  brain  and  thickened  dura 
mater  filled  the  frontal  sinuses. 

How  can  this  strange  disease  be  accounted  for  ?  If  the 
patient  had  been  human,  syphilis  or  mercury  would  have  been 
blamed ;  but  here  was  a  patient  that  had  never  been  mer- 
curialized, never  syphilitic.  It  might  with  reason  be  said  that 
the  attack  of  phrenitis  had  led  to  the  brain  enlargement,  and 
that  the  absorption  of  the  cranial  bones  had  resulted  from 
internal  pressure  from  the  growth  of  the  cerebral  mass.  But 
how  about  the  facial  bones  ?  Was  the  altered  structure  of  the 
fifth  pair  of  nerves  sufficient  to  account  for  this  ?  My  colleague, 
Dr.  Young,  is  of  opinion  that  the  disease  was  primarily  in  the 
bones,  and  that  the  pathological  alterations  found  in  the  brain 
and  nerves  were  a  result  of  the  osseous  change. 

OSTEO-POROSIS. 

This  disease  was  first  described  in  this  country  by  Professor 
Vamell,  in  the  Veterinarian  of  1860.  It  appears  from  his 
careful  and  elaborate  report  that  at  one  farm  near  Eeading, 
no  fewer  than  six  horses  had  been  affected  Avith  this  strange 
malady  when  he  reported  upon  it.  Since  then,  however,  many 
practitioners  have  witnessed  it,  and  all  agree  that  Mr.  Varnell's 
report  is  a  most  faithful  one.     Mr.  Anderson  of  Glasgow,  and 


OSTEO-POROSIS. 


185 


Mr.  Robinson  of  Greenock,  have  seen  it  frequently ;  and  I  am 
indebted  to  them  for  many  valuable  hints  upon  the  peculiarity 
of  the  symptoms,  and  for  specimens  of  the  bones  of  the  head 
sufferincc  fi'oni  the  disease. 


Fig.  31. 


Fig.  32. 


Figs.  31  and  32. — Cranio-facial  bones  affected  with  osteo-porosis ;  the 
front  view,  Fig.  31,  representing  the  enlarged  condition  of  the  face  ;  and 
Fig.  32  showing  the  disease  extended  into  the  alveolar  cavities. 

As  a  rule,  the  bones  of  the  face  are  the  first  to  suffer ;  but 
this  is  liable  to  exceptions,  as  the  following  extracts  from  the 
Veterinarian  of  1860  wiU  show.  The  symptoms  were  de- 
scribed to  Mr.  Varnell  by  a  Mr.  Wallin :— "  My  attention,"  says 
Mr.  "Wallin,  "  was  in  most  instances  first  directed  to  defective 
action,  perhaps  in  one  joint  or  limb  only,  in  which,  upon  exami- 


186  NON-INFLAMMATORY  DISEASES  OF  BONES. 

nation,  tenderness  would  be  evinced,  with  inordinate  heat,  and 
in  a  few  days  visible  enlargement  would  be  observed  to  exist. 
In  the  course  of  a  week,  or  thereabouts,  another  of  the  limbs 
would  become  affected  in  the  same  way,  when  the  acute  symp- 
toms of  the  first  attacked  would  perhaps  have  partially  passed 
off.  In  this  way  all  the  four  extremities,  one  after  the  other, 
eventually  became  diseased.  The  appetite  was  generally  good, 
and  for  a  time  the  animals  did  not  lose  flesh  very  fast ;  but  after 
a  while,  from  the  great  constitutional  disturbance  set  up,  they 
fell  off  in  their  appetites,  and  began  to  waste  very  rapidly.  The 
pulse  seldom  rose  much  above  the  natural  standard,  and  the 
excretions  appeared  to  be  natural." 

It  appears  that  these  horses  had  been,  all  but  one,  bred  on  the 
same  farm,  and  were  the  offspring  of  different  mares  and  different 
sires.  The  facts  gained  by  Professor  Varnell  are  very  interest- 
ing, and  may  be  briefly  stated  as  follows : — 

They  had  been  fed  on  the  same  food  as  other  horses  on  the 
farm  which  had  never  shown  any  symptoms  of  the  disease. 
The  owner  had  been  in  the  habit  of  feeding  his  horses  in  the 
same  way  for  years  without  any  previous  ill  effects.  Bran  or 
pollard,  along  with  the  ordinary  produce  of  the  farm,  formed 
the  greater  part  of  their  diet.  They  all  drank  the  same  kind 
of  water  as  the  other  stock.  Professor  Varnell  examined  the 
food  they  were  getting,  and  pronounced  it  good.  It  appears 
that  male  animals  only  were  attacked ;  none  of  the  fillies  had 
ever  been  affected  with  the  disease.  Another  fact  that  Professor 
Varnell  mentions  is  most  interesting,  namely,  that  the  gentleman 
had  another  farm  a  short  distance  only  from  when  the  disease 
existed.  On  that  farm  not  a  single  instance  occurred,  although 
the  horses  were  bred  from  the  same  parents,  and  partook  of  the 
same  kind  of  food.  I  will  detail  the  symptoms  in  the  two 
animals  that  were  suffering  at  the  time  of  his  visit  in  Professor 
Varnell's  own  words.  He  says : — "  I  was  first  shown  a  brown 
cart-horse,  five  years  old.  He  was  standing  in  the  cart-horse 
stable  with  other  horses ;  was  in  very  fair  condition,  and  at  first 
sight  appeared  as  if  nothing  were  the  matter  with  him ;  the 
pulse  was  only  a  little  above  the  ordinary  standard,  and  the 
excretions,  as  far  as  I  could  see  or  learn,  were  natural.  I 
ordered  him  to  be  led  out  of  the  stable,  when  I  observed  that 
Jie  stepped  short,  flexed  his  limbs  with  difficulty,  and  apparently 


OSTEO-POROSIS.  187 

with  much  pain,  particularly  the  near  fore  and  the  off  hind  legs, 
the  knee  and  hock  joints  of  which  were  hotter  than  natural, 
slightly  swollen,  and  tender  when  pressed  upon.  These  symp- 
toms were  also  present  in  the  other  two  limbs,  but  in  a  much 
less  degree  of  intensity.  On  causing  the  horse  to  be  turned 
round,  or  moved  in  a  backward  direction,  a  decidedly  rigid  state 
of  the  loins  was  observed,  and  by  pressing  upon  any  part  of  the 
back  considerable  pain  was  evinced.  On  examining  the  animal's 
head,  I  was  particularly  struck  with  the  enlarged  and  roundish 
appearance  of  the  facial  region.  Each  ramus  of  the  lower  jaw^ 
the  upper  maxillary,  and  the  nasal  bones  were  evidently  en- 
larged, and  pressure  on  them  caused  some  amount  of  pain.  On 
looking  into  the  mouth,  I  observed  that  the  mucous  membrane 
was  of  a  purplish  tint,  except  at  the  margin  of  the  gums,  where 
it  was  of  a  pinkish  colour,  crossed  here  and  there  by  bluish 
lines  (veins).  The  lining  membrane  of  the  nasal  passages  and 
the  conjunctival  membrane  also  were  paler  than  natural.  This 
condition  of  the  membranes,  I  was  assured  by  Mr.  Wallin,  could 
not  have  been  caused  by  any  medicine  that  had  been  given." 

In  the  other  case,  a  chesnut  horse,  which  Professor  Varnell 
examined,  the  joints  were  swollen,  hot,  and  tender ;  there  was  the 
same  rigidity  of  the  back,  and  the  peculiar  colour  of  the  mucous 
membranes;  but  the  enlargement  of  the  bones  did  not  exist. 
This  case  had  been  ill  for  about  six  months. 

The  ;post  mortem  examination  revealed  the  following  condition 
of  parts : — The  internal  organs,  with  the  exception  of  a  peculiar 
pallor,  showed  no  marks  of  disease.  The  chesnut  horse  was  sent 
to  London,  and  on  his  arrival  at  Paddington  Station  he  was 
found  unable  to  walk  from  the  horse-box  to  the  van  that  was 
sent  to  take  him  to  the  Eoyal  Veterinary  College.  On  his 
attempting  to  walk,  his  fore  legs  gave  way  at  the  elbow-joint  on 
one  side,  and  the  shoulder-joint  on  the  other,  in  consequence  of 
the  articular  and  capsular  ligaments,  and  the  tendons  of  the 
muscles,  which  are  attached  near  to  these  joints,  becoming 
detached  (as  was  found  to  be  the  case  afterwards)  from  their 
bony  connections,  by  the  tearing  away  of  portions  of  diseased 
bones.  The  horse  was  destroyed  upon  the  spot,  and  the  carcase 
taken  to  the  College  for  dissection.  "The  soft  parts,"  says 
Professor  Varnell,  "  generally  were  paler  than  is  natural,  especi- 
ally the  muscles  of  those  limbs  which  had  been  thrown  out  of 


188  ^  NON-INFLAMMATORY  DISEASES  OF  BONES. 

use  from  the  pain  produced  whenever  any  movement  was  at- 
tempted to  be  made.  But  in  these  structures  I  did  not  detect 
the  slightest  traces  of  fatty  degeneration.  The  fat  generally  had 
a  mottled,  watery  appearance,  which  is  very  common  in  animals 
that  are  rapidly  losing  flesh,  and  this  had  been  the  case  in  a  very 
marked  degree  for  a  short  time  before  the  horse  was  destroyed. 
In  disarticulating  the  limbs  from  the  trunk,  and  also  the  several 
bones  of  each  limb  one  from  the  other,  the  appearance  of  the 
interior  of  each  joint  was  remarkable.  In  most  instances, 
although  not  in  all,  the  articular  cartilage  was  of  a  dark  slate 
colour,  much  thinner  than  is  natural,  and  in  many  places  it  was 
entirely  lost.  This  was  especially  the  case  round  the  margin  of 
the  articulations,  leaving  the  bone  at  that  part  quite  exposed. 
The  synovial  membrane  was  considerably  thickened,  especially 
in  those  parts  where  it  is  most  vascular.  The  quantity  of 
synovia  in  each  joint  was  small,  of  a  dark  colour,  and  in  some 
cases  mixed  with  blood.  The  character  of  some  of  the  articu- 
lating surfaces,  however,  was  quite  different.  In  such,  the  arti- 
cular cartilage  was  pale-coloured,  and  in  some  places  of  a 
palish  yellow,  velvety  to  the  feel,  and  evidently  containing  fat ; 
thereby  indicating  that  the  cartilage  cells  had  disappeared,  and 
fat  had  become  deposited  in  their  place.  The  ends  of  the  bones 
were  so  much  softened,  that  by  applying  a  slight  degree  of  force 
.to  the  capsular  or  articular  ligaments,  small  portions  of  the  bone 
could  easily  be  detached.  The  periosteal  covering  of  the  flat 
and  irregular,  and  also  some  parts  of  the  long  bones,  was  very 
vascular,  and  could  easily  be  stripped  off.  The  bones  generally 
were  likewise  so  very  soft  that  they  could  be  cut  with  a  knife 
in  any  direction  with  the  greatest  ease;  and  if  pressure  were 
applied  to  the  cut  surfaces,  or  where  the  periosteum  had  been 
removed,  blood  would  ooze  from  numerous  points.  In  the 
interior  of  the  bones  the  cancelli  were  filled  with  a  red  gelatin- 
ous substance.  The  ribs,  the  vertebrse,  and  indeed  all  the  irre- 
gular and  flat  bones,  were  in  the  same  condition.  The  shafts  of 
the  long  bones  of  the  extremities  were  not  visibly  increased  in 
size,  nor  was  the  shell  or  compact  structure  much  altered.  The 
ends  of  these  bones,  however,  were  enlarged  and  soft ;  and  on 
making  a  section  through  them,  in  their  long  diameter,  the 
medullary  canal,  and  especially  the  cancelli  near  to  the  extremi- 
ties, had  a  singular,  although  not  a  uniform,  appearance.     In 


OSTEO-POROSIS.  189 

some  of  tliem,  the  whole  of  the  interior  was  of  a  dark  red  colour, 
from  congestion  of  the  vessels  and  effusion  of  blood  into  the 
areolar  interspaces ;  in  others,  one-half  only  of  the  interior  was 
in  this  state,  the  other  part  being  filled  with  a  peculiar  fat,  and 
consequently  very  pale  in  colour.  It  was  at  the  end  of  the  bone 
affected  in  this  way  that  the  articular  cartilage  was  of  a  palish 
yellow  colour,  velvety  to  the  feel,  and  also  slightly  greasy.  Even 
the  teeth  did  not  escape  the  malady,  one  of  their  constituents 
being  evidently  affected,  which  was  evinced  by  the  crusta  petrosa 
being  much  thicker  and  more  spongy  than  natural." 

The  pathological  anatomy  of  the  bones  was  investigated  by 
Dr.  G.  Harley,  and  communicated  to  Professor  Varnell  in  a 
letter,  dated  21st  March  I860:— "The  horse's  bones  which 
I  examined  for  you  presented  two  well-marked  varieties  of 
morbid  change,  one  of  which  was  most  characteristically  seen 
in  the  bones  of  the  head,  the  other  in  the  long  bones  of  the 
extremities. 

"  1st.  As  regards  those  of  the  head.  The  disease,  although 
it  affected  all  the  bones,  was  most  advanced  in  the  lower  jaw. 
I  shall  therefore  limit  my  remarks  to  a  description  of  it.  The 
bone  was  considerably  hypertrophied  in  its  tranverse  diameter ; 
the  periosteum  readily  detached;  the  osseous  tissue  was  of  a 
pink  colour,  and  on  pressure  a  quantity  of  blood  oozed  from  its 
surface,  as  if  from  a  sponge.  The  osseous  tissue  was  elastic  to 
the  touch,  and  so  soft  that  it  could  with  facility  be  cut  with  a 
knife.  The  surface  of  the  section  had  a  somewhat  fleshy  appear- 
ance, but  to  the  nail  it  conveyed  rather  the  impression  of  carti- 
lage. When  examined  microscopically  the  osseous  tissue  was 
seen  to  be  expanded  into  a  network  of  fine  fibres.  The  Haver- 
sian canals,  on  the  other  hand,  have  become  so  enlarged  that  at 
first  sight  they  might  be  mistaken  for  bony  tissue,  and  the  bony 
tissue  mistaken  for  the  Haversian  canals.  On  examination  with 
a  higher  power,  not  only  is  the  osseous  tissue  seen  to  be  rarefied, 
but  the  canaliculi  proceeding  from  the  lacunae  or  bone  corpuscles, 
i{s  they  were  formerly  called,  are  in  many  cases  obliterated.  The 
lacunse  themselves  are  also  not  so  distinct  as  in  healthy  bone. 
The  enlarged  Haversian  spaces  are  filled  with  a  gelatinous 
matter,  mingled  with  a  small  portion  of  fat,  and  here  and  there 
pervaded  with  fine,  scarcely  visible  fibres. 

"  2d.  Long  Bones  of  the  Extremities. — The  periosteum,  although 


190  NON-INFLAMMATORY  DISEASES  OF  BONES. 

readily  detached,  does  not  come  away  with  so  much  fticility  as 
from  the  bones  of  the  head,  except  towards  the  ends  of  the  bones, 
where,  strange  to  say,  the  ligaments  had  become  detached  by  the 
mere  movements  of  the  animal  during  life.  The  outer  surface  of 
the  shaft  of  the  bone  is  firm  enough,  but  on  section  it  is  found 
to  be  greatly  thinned,  in  consequence  of  an  enlargement  of  the 
medullary  canal  having  taken  place  at  the  expense  of  the  osseous 
structure. 

"  The  dilatation  of  the  medullary  cavity  is  most  marked 
towards  the  extremities  of  the  bone,  and  there  the  marrow  is 
deeply  tinged  with  blood.  The  osseous  tissue,  which  in  some 
parts  is  reduced  to  one-half,  or  even  one-third  of  its  normal 
thickness,  does  not  present  the  spongy  appearance  of  the  cranial 
bones,  but,  on  the  contrary,  is  dense,  and  so  hard  that  it  cannot 
be  cut  with  a  knife. 

"  After  the  calcareous  matter  is  removed  by  acid,  the  section 
of  the  animal  matter  has  a  somewhat  glistening  cartilaginous 
appearance,  here  and  there  dotted  with  opaque  white  spots. 
Under  the  microscope,  a  thin  section  reveals  a  curious  condition 
of  tilings  ;  the  Haversian  canals,  as  well  as  the  concentric  bony 
lamellse  surrounding  them,  appear  perfectly  normal.  The  lacunse 
and  canaliculi,  as  far  as  can  be  ascertained  in  the  decalcified 
bone,  are  equally  healthy ;  but,  on  close  inspection,  the  opaque 
white  spots  observed  by  the  naked  eye  are  seen  to  be  irregu- 
larly shaped  cavities  in  the  osseous  tissue,  filled  with  fat  cells. 
These  cavities  vary  in  size,  from  that  of  a  pin's  point  to  a  millet- 
seed.  They  are  not  limited  to  any  particular  portion  of  the 
osseous  structure,  although  they  seem  to  have  commenced,  for 
the  most  part,  in  the  lacunse.  Some,  however,  may,  with  equal 
truth,  be  said  to  have  originated  in  the  Haversian  canals,  the 
walls  of  which  have  been  gradually  broken  down  and  eaten 
away,  as  the  morbid  condition  advanced ;  the  place  of  the 
earthy  and  animal  matter  being  gradually  taken  up  by  fat 
corpuscles." 

Professor  Yarnell  says,  in  continuation  of  his  most  admirable 
description,  that  "  the  bones,  after  being  macerated  and  dried, 
exhibited  many  peculiarities  which  were  not  apparent  in  their 
fresh  state ;  for  instance,  the  ulceration  of  the  articular  surfaces, 
which  seemed  to  be  altogether  confined  to  the  cartilages  of 
incrustation,  was  found  on  their   removal  to   affect  the  bone 


OSTEO-POROSIS.  191 

beneath ;  and  the  loss  of  structure,  however  small  it  might  be 
in  the  cartilage,  extended  more  or  less  deeply  into  the  bone ; 
the  size  of  the  cavity  increasing  with  its  depth.  This  fact,  I 
think,  proves  beyond  disputation  that  the  loss  of  the  cartilage 
depended  primarily  upon  the  diseased  condition  of  the  bone, 
and  that  the  general  thinning  of  the  cartilage  arose  from  the 
same  cause.  Scarcely  an  articulation  of  the  whole  body  was 
free  from  this  *  worm-eaten'  condition  of  both  bone  and  cartilage. 

"  It  was  found  likewise,  in  cleaning  the  bones  after  macera- 
tion, that,  from  their  extreme  softness,  great  care  was  necessary  to 
prevent  their  different  processes  (epiphyses)  from  being  detached, 
and  the  application  of  the  slightest  force  to  a  portion  of  ligament 
or  tendon,  that  was  not  sufficiently  separated  by  decomposition, 
would  be  certain  to  effect  their  removal. 

"  The  external  surfaces  also  of  the  bones,  as  contrasted  with 
those  in  a  normal  condition,  had  a  very  singular  aspect,  especially 
in  the  flat  and  irregular  bones.  The  ends  of  the  long  bones  were 
similarly  affected,  but  the  shafts  of  most  of  them  deviated  but 
little  in  external  appearance  from  a  healthy  state.  A  trans- 
verse section,  however,  of  the  middle  of  the  shaft  showed  very 
distinctly  that  the  osseous  laminae  surrounding  the  Haversian 
canals  were  very  much  thinner  than  is  natural,  thus  necessarily 
leading  to  a  considerable  enlargement  of  the  latter.  In  the  first- 
named,  however,  and  in  the  flat  bones,  instead  of  the  surface 
being  smooth  and  dense,  it  had  a  character  not  very  unlike  a 
fine  sponge.  The  foramina  for  the  passage  of  the  blood-vessels, 
and  especially  those  belonging  to  the  periosteal  membrane,  were 
much  dilated,  thus  giving  the  bone  a  kind  of  honeycomb  appear- 
ance." (Figs.  30  and  31  illustrate  this  peculiar  appearance  very 
well.) 

It  is  found  that  the  weight  of  ^the  bones  is  much  diminished 
in  osteo-porosis.  The  articular  surfaces  undergo  changes  that 
are  peculiar;  thus,  in  Professor  Varnell's  cases,  the  articular 
cartilage  upon  one  end  of  the  femur  was  much  thinner  than 
is  natural,  of  a  dark  slate  colour  in  some  places,  and  alto- 
gether lost  in  others ;  the  bone  beneath  it  being  very  soft,  and 
almost  black  from  congestion  of  its  vessels  and  extravasation 
of  blood  into  its  interstices.  On  the  other  end  of  the  bone,  the 
cartilage  w^as  in  a  different  condition,  pale  in  colour,  and  in 
some  places  of  a  yellowish  hue,  soft  and  velvety  to  the  touch, 


192  NON-INFLAMMATORY  DISEASES  OF  BONES. 

and  containing  a  small  quantity  of  fat.  Beneath  the  cartilage 
the  bone  was  found  soft,  the  lamellae  very  thin,  with  the  inter- 
spaces filled  with  a  greasy  white-looking  substance,  fat,  and  the 
extremity  of  the  bone  generally  non-vascular.  The  synovial 
membrane  was  much  thickened  in  some  joints,  but  the  quantity 
of  synovia  in  all  was  small,  dark  in  colour,  and  in  some  cases 
mixed  with  clots  of  blood.  The  periosteum  of  all  the  bones 
was  easily  stripped  off,  and  the  bones  themselves  were  soft 
and  easily  cut  with  the  knife.  Within  the  bones  the  cancelli 
were  filled  with  a  red  gelatinous  substance.  The  ribs,  the 
vertebrae,  and  all  the  irregular  and  flat  bones  were  in  the  same 
condition.  The  shafts  of  the  long  bones  were  externally  but 
little  different  from  healthy  ones;  but  on  making  a  longitu- 
dinal section  of  them,  the  medullary  canal  and  the  cancellated 
spaces  near  their  extremities  were  dark  red  in  colour,  from  con- 
gestion of  the  vessels  and  extravasation  of  blood  into  the 
areolar  spaces.  In  other  parts  a  peculiar  fat  was  found,  giving 
a  paleness  to  the  colour ;  and  the  bones  were  near  their  ends  so 
filled  that  the  cartilage  appeared  to  be  of  a  palish  yellow  colour, 
and  was  velvety  and  slightly  greasy  to  the  touch. 

In  some  cases  the  teeth  do  not  escape ;  the  crusta  petrosa 
being  evidently  increased  in  thickness,  and  more  spongy  than 
natural.  No  class  or  breed  of  horses  seems  exempt  from  this 
disease,  as  I  have  records  of  cases  of  it  in  carriage  horses,  in 
ponies,  and  in  thorough-bred  ones,  whilst  Professor  Varnell's 
cases  belong  to  the  cart  breed.  In  no  instances  have  I  heard  or 
seen  it  affecting  horses  above  six  years  old ;  frequently,  indeed, 
the  animals  have  ranged  from  two  up  to  four  years  old.  In  my 
experience  males  only  have  been  attacked  by  it.  Professor  VarneU 
enters  into  a  very  lucid  examination  of  the  cause,  and  leaves  one 
with  the  impression  that  it  is  due  to  food  or  water  deficient  in 
the  salts  of  lime ;  but  my  experience  goes  to  prove  that  food  and 
water  have  nothing  to  do  with  it,  nor  can  I  conclusively  trace  it  to 
any  peculiar  geological  formation  or  particular  locality.  One  of 
Mr.  Eobinson  of  Greenock's  cases  was  attacked  while  in  London, 
during  the  summer  season,  with  symptoms  analogous  to  those  of 
rheumatism,  and  all  his  cases  were  well-cared-for  animals.  It  has 
been  witnessed  in  Shetland  ponies.  In  America  the  disease  is 
called  Big-head,  from  the  peculiar  swollen  state  of  the  jaws ;  it  is 
there  supposed  to  be  due  to  the  feeding  upon  maize,  and  it  has 


OSTEO-POROSIS.  193" 

latterly  appeared  in  thorougli-bred  stock  in  Australia,  where 
it  is  erroneously  ascribed  by  some  to  forcing  the  growth  of  the 
young  by  over-feeding. 

Osteo-porosis  is  not  confined  to  the  horse  and  sheep ;  cattle 
reared  on  bad  ill-drained  land,  poorly  kept  in  the  winter,  grazed 
on  sterile  upland  pastures  during  dry  summers,  oi  otherwise  ill- 
used,  being  liable  to  be  affected  with  it.  They  present  symptoms 
of  rheumatic  lameness,  terminating  in  spontaneous  fracture  of 
the  bones  involved. 

The  disease  in  sheep,  as  explained  by  the  following  history, 
kindly  supplied  by  Mr.  Eobertson  of  Kelso,  is  not  uncommon. 

"  Sheep  of  all  breeds  and  of  every  age  are,  under  certain  con- 
ditions of  soil  and  cultivation,  externally  liable  to  a  peculiar 
form  of  non-inflammatory  disease  of  bone,  more  nearly  resem- 
bling osteo-porosis,  as  here  described,  than  aught  else  I  am 
aware  of. 

"  Every  appearance  of  this  disease  with  which  I  am  acquainted 
has  been  in  stock  pastured  on  what  is  known  as  weak  moor- 
land, recently  reclaimed  and  limed,  or  fed  with  roots  grown  on 
soil  of  this  character  undergoing  reclamation.  It  is  deserving 
of  notice  that  so  long  as  this  class  of  soil  is  left  undisturbed, 
the  sheep,  although  grazing  sparsely,  are  in  good  health ;  but  no 
sooner  is  it  drained  and  limed,  and  put  under  such  rotation  as  is 
deemed  best  fitted  to  accelerate  its  being  laid  down  again  to 
grass,  than  a  strange  class  of  diseases  make  their  appearance 
amongst  the  sheep  confined  to  this  land;  amongst  the  most 
conspicuous  of  these  affections  is  this  peculiar  bone  disease. 

"  There  is  nothing  either  in  the  general  health  of  the  sheep, 
their  powers  or  manner  of  locomotion,  or  external  appearance 
of  the  bones,  which  afterwards  show  so  much  alteration  of 
structure,  to  attract  attention,  or-  even  raise  the  suspicion  that 
the  animals  are  not  in  good  health  and  doing  well. 

"  The  first  indication  that  there  is  aught  seriously  wrong  is  in 
all  probability  the  finding  some  morning  of  one  or  more  of  the 
flock  helpless  from  a  fractured  limb ;  or  this  condition  may  be 
observed  actually  to  occur  while  the  sheep  are  being  turned 
by  a  dog  in  the  usual  course  of  telling  and  inspection. 

"  The  fractures,  as  a  rule,  occur  in  the  long  bones  of  the  limbs. 
On  carefully  examining  these  bones,  there  is  frequently  little  to 
be  observed  of  an  abnormal  nature  on  their  exterior  surface. 

0 


194  KON-INFLAMMATORY  DISEASES  OF  BONES. 

Occasionally  the  periosteum  will  be  thicker,  more  vascular 
and  more  easily  stripped  off;  the  fractured  surfaces,  however, 
or  such  as  are  exposed,  on  making  a  section  through  the  shaft, 
disclose  great  general  vascularity,  and  consequent  heightening 
in  colour. 

"  The  medulla  appears  not  only  to  contain  an  extra  amount  of 
blood-vessels  loaded  with  blood,  but  at  many  parts  these  seem 
to  have  ruptured,  and  extravasation  to  have  occurred.  This 
heightening  in  colour  and  extravasation  of  blood  is  not  only 
present  in  the  large  nutrient  canal,  but  distributed  throughout 
the  entire  nutrient  system  of  the  bone.  Obvious  alteration  of 
structure  in  all  these  cases  is  found  to  exist  both  in  the  compact 
tissue  of  the  shaft,  and  in  the  entire  cancellated  and  compact 
tissue  of  the  extremities.  In  the  former,  the  bony  laminae 
surrounding  the  Haversian  canals  are  expanded,  opened  out, 
and  thinner,  resulting  in  a  consequent  dilatation  of  these  latter  ; 
the  same  conditions  exist  to  an  equal  extent  in  the  cancellated 
tissue  of  the  extremities. 

"  Although  this  rarefaction  of  the  true  bone  tissue  may  have 
proceeded  to  a  great  extent,  leaving  merely  a  thin  shell  of  com- 
pact bone  around  the  great  medullary  canal,  in  no  case  is  there 
an  entire  want  of  bony  matter,  or  a  replacement  of  this  by 
cartilaj^inous  or  fattv  tissue.  The  bone  will  not  cut  with  a 
knife,  but  may  be  fragile  enough  to  admit  of  being  crushed  on 
the  application  of  even  moderate  force. 

"  It  is  no  doubt  from  this  apparent  condition  of  the  extra 
amount  of  blood  contained  in  the  vessels  and  nutrient  canals, 
its  effusion,  and  the  very  dark  colour  imparted  to  the  bones, 
which  has  led  ordinary  observers  to  speak  of  them  as  being  in  a 
state  of  rottenness  and  decay. 

"  Although  all  breeds  and  ages  of  sheep,  w^hen  circumstanced 
as  stated,  seem  liable  to  be  thus  affected,  I  have  met  with  it 
most  frequently  amongst  cross-bred  sheep,  and  in  these  when 
under  two  years  of  age,  most  probably  because  they  are  the 
class  of  sheep  most  frequently  subjected  to  the  adverse  in- 
fluences mentioned. 

"  In  regard  to  the  treatment  of  this  disease,  we  can,  from  ex- 
periments which  have  been  carried  out,  speak  with  tolerable 
certainty  as  respects  the  efficacy  of  preventive  measures.  When 
sheep  are  placed  either  on  pasture  or  on  roots,  with  such  con- 


OSTEO-POROSIS.  195 

ditions  of  soil  and  cultivation  as  indicated,  the  addition  to 
this  natural  diet  of  from  one  quarter  to  one  half  pound  daily 
of  some  nutritious  material,  as  linseed  cake,  or  a  mixture  of 
linseed  cake,  oats,  and  bran,  serves  effectually  to  prevent  the 
occurrence  of  this  diseased  condition ;  while,  when  such  has 
declared  itself,  a  change  to  a  better  soil  and  a  different 
geological  formation  will,  in  combination  with  supplemented 
food,  materially  hasten  a  restoration  to  robust  health. 

"At  one  time  it  was  believed,  and  many  still  hold  to  the 
opinion,  that  the  immediately  operating  cause  in  the  production 
of  this  diseased  condition  of  bone  was  the  presence  of  lime  salts 
in  the  soil,  the  result  of  the  added  alkali,  and  their  transference 
to  and  appropriation  by  the  animal  system,  thus  producing  a 
fragility  of  bone  from  excess  of  earthy  constituents.  Chemical 
analysis  of  these  bones  has,  however,  disallowed  this  theory, 
even  if  it  were  not  untenable  on  other  grounds. 

"  It  seems  most  probable  that  tliis  condition  of  mal-nutrition  is 
rather  to  be  regarded  as  resulting  from  certain  changes  which 
the  treatment  of  the  soil  has  brought  about,  in  the  material 
produced  therefrom,  and  their  unfitness  when  received  into 
the  animal  body  for  the  elaboration  of  healthy  tissue,  than 
from  the  passage  in  an  unchanged  form  of  any  material  already 
existing  in  the  soil  into  the  component  structures  of  the  animal 
body." 

In  concluding  this  subject,  I  must  give  it  as  my  own  opinion 
that  the  disease  is  due  to  development  of  the  vascular  and 
fibrous  structures  of  the  bones,  without  a  corresponding  growth 
of  the  true  osseous  and  cartilaginous  elements ;  and  in 
support  of  this  view  I  here  quote  from  Eokitansky,  who 
says — "  Osteo-porosis  consists  of  the  excessive  development  of 
the  tissues  which  occupy  the  canals  and  cells  of  the  bones; 
whilst  at  the  same  time  the  actual  quantity  of  bony  matter 
remains  unaltered."  The  growth  of  the  contents  of  the  canals 
and  cells  must  naturally  cause  a  rarefaction  of  their  walls,  and 
the  bone  becomes  increased  in  volume,  expanded,  as  the  walls  of 
the  expanding  cavities  become  thinner  and  thinner,  till  at  length 
apertures  are  formed,  and  cavities  which  communicate  one  with 
the  other,  containing  a  dark  red  medulla,  traversed  by  dilated 
vessels,  and  which  sometimes  become  ruptured,  and  the  cavities 
become   filled  by  loose  or  firm  clots  of  blood.     The  fact  that 


196  NON-INFLAMMATORY  DISEASES  OF  BONES. 

osteo-porosis  lias  not  been  recorded  in  aged  horses  points  out 
most  strongly  that  it  is  a  disease  of  growth ;  and  the  circnm- 
stance  of  the  bones  being  fragile  and  easily  broken,  confirms 
the  view  that  the  cartilaginous  basis,  as  well  as  the  earthy 
constituents,  is  not  developed ;  for  were  the  disease  due  to  non- 
development  of  earthy  matter  only,  the  bones  would  bend,  being 
more  elastic  than  is  natural ;  but  in  this  disease  they  are  brittle, 
owing  to  the  absence  of  the  tough  animal  basis  in  sufficient 
quantity. 

Osteo-porosis  is  confounded  with  fatty  degeneration  of  bone, 
but  it  is  quite  different,  both  physically  and  chemically.  In  the 
one  case,  the  bone  is  pink  or  dark  red,  and  hydrochloric  acid 
produces  but  little  change;  but  in  fatty  disease  the  bone  is 
yellowish  ;  and  all  that  is  left  of  a  piece  subjected  to  the  action 
of  the  acid  is  a  small  quantity  of  an  amorphous  greasy  substance. 
In  fatty  degeneration  the  cartilage  degenerates  into  fat ;  in  osteo- 
porosis it  is  not  developed  sufficiently,  the  bulk  of  the  bone 
being  composed  of  vascular  and  fibrous  structures  mixed  with  a 
portion  of  spongy  bone ;  hence  they  are  frail,  and  liable  to  fracture. 
In  one  of  Mr.  Robinson's  cases  both  fore  legs  were  broken  before 
the  animal  was  destroyed. 

It  would  be  hazardous  in  our  present  state  of  knowledge  to 
condescend  upon  the  cause  or  causes  of  osteo-porosis,  for  it  will 
be  gathered  from  the  foregoing  observations  that  animals  of 
every  class,  no  matter  how  treated,  are  subject  to  it;  the 
race-horse,  from  supposed  over-feeding  and  over-forcing ;  cattle 
from  the  want  of  proper  food;  and  sheep  when  placed  upon 
pastures  which  have  been  improved  by  draining  and  liming. 

Continental  writers  recommend  the  curative  treatment  of  the 
disease.  In  this  country  everything  that  has  been  done  to 
arrest  its  progress,  such  as  good  food,  tonics,  alteratives,  the 
best  of  attention,  ventilation,  &c.,  have  all  proved  futile  when 
it  had  once  been  established.  We  must  therefore  conclude  with 
Mr.  Eobertson  that  its  prevention  is  to  be  aimed  at,  and 
measures  taken  for  that  purpose  in  every  case  where  animals 
are  placed  under  conditions  or  pastured  upon  land  favourable  to 
its  development,  by  making  such  additions  to  their  natural 
diet  as  to  blend  the  whole  food  into  a  perfect  pabulum,  fit 
for  the  nourishment  of  aU  the  tissues  of  the  body  ;  for  in  all 
probability  it  will  yet  be  discovered  that  the  disease  is  due  to 


OSTEO-POROSIS.  197 

the  absence  of  some  essential  ingredient  of  the  food,  or  its  pre- 
sence in  such  small  quantities  as  to  be  insufficient  for  the 
necessities  of  the  animal ;  or  the  presence  of  some  other  con- 
stituent of  the  food  in  such  super-abundance  as  to  destroy  the 
perfect  composition  of  the  aliment  as  a  whole,  and  thus  render 
it  unfit  for  assimilation  by,  or  so  change  it  as  to  cause  it  to  become 
even  an  irritant  to,  the  osseous  system  of  the  animal. 


FRAGILITUS  OSSIUM. 

Fragility  of  bones  results  from  two  pathological  conditions, 
namely — Is^.  Fatty  degeneration  of  the  animal  basis ;  and  2d. 
The  presence  of  an  undue  quantity  of  earthy  materials,  due  to 
old  age  or  to  ostitis. 

The  first  form  is  a  constitutional  disease,  with  no  symptoms 
indicative  of  its  presence  during  life,  discovered  only  after  a 
fracture  of  such  a  nature  as  to  be  incurable,  and  when  the  animal 
is  examined  after  death. — (See  Photo-lithograph,  Plate  I.,  Fig. 
1 .)  I  have,  however,  observed  that  narrow-loined  horses  are  liable 
to  this  disease — bad  thrivers,  as  they  are  called^ — with  small 
articulations,  badly-formed  hocks  and  knees,  round  pasterns, 
&c.,  and  having  a  tendency  to  fall  lame  from  bone-spavins,  ring- 
bones, or  other  osseous  diseases.  As  a  rule,  they  are  middle- 
aged  horses,  and  the  post  mortem  examination  shows  the  bones 
— ^more  especially  the  pelvic  and  vertebral — in  a  peculiar  greasy 
condition,  yellowish  in  colour  throughout  their  substance,  and 
with  their  cancelli  filled  with  a  dirty  yellowish  fat.  When 
microscopically  examined,  the  minute  structure  of  the  bone  is 
found  to  be  filled  with  fat  globules ;  in  fact,  their  structure 
is  not  only  infiltrated,  but  partly  composed  of  fat,  traversed,  as  it 
were,  by  the  natural  bony  material. 

Writers  upon  surgery  describe  fatty  degeneration  of  bone 
under  the  head  of  mollities  ossium,  or  softening  of  the  bones ; 
indeed,  there  seems  to  be  a  confusion  amongst  them  on 
this  subject,  some  giving  the  pathological  anatomy  of  osteo- 
porosis, others  of  fatty  degeneration.  Paget,  however,  says 
that  two  diseases  are  described  as  mollities  ossium,  namely, 
fatty  degeneration,  and  the  simpler  softening  of  bone,  or  osteo- 
malacia rhachitismus  adultorum,  in  which  the  bones  are  flexible 
rather  than  brittle. 


198  NON-INFLAMMATORY  DISEASES  OF  BONES. 

The  case  related  at  page  183  goes  to  prove  that  the  two 
conditions  are  quite  distinct  in  the  horse,  as  in  that  case  there 
was  simply  a  removal  of  the  earthy  constituents,  rendering  the 
bones  flexible  and  easily  cut  with  the  knife.  I  contend  this 
is  the  true  mollities  ossium;  whereas  in  the  disease  now  under 
consideration  fatty  material  is  substituted  for  the  cartilaginous 
basis,  without  removal  of  the  earthy  matter,  and  in  this  way 
the  bones  are  rendered  brittle,  and  liable  to  fracture  from 
unappreciable  causes. 

The  second  form  of  fragilitus  ossium,  resulting  from  old  age, 
can  scarcely  be  looked  upon  as  a  disease,  since  it  is  as  much 
the  natural  state  of  the  senile  skeleton  as  the  soft  pliable  con- 
dition of  the  bones  is  that  of  adolescence. 

Bones,  when  affected  by  chronic  inflammation,  however,  are 
rendered  exceedingly  brittle  and  liable  to  fracture ;  and  it  is 
interesting  to  note  the  progress  of  ostitis  leading  to  such  a 
condition.     First  of  all,  if  the  extremity  of  a  bone  be  examined, 
by  making  a  section  of  it,  when  in  the  early  stages  of  inflam- 
mation, it  will  be  discovered  that  the  first  change  has  been  the 
removal  of  the  fat  from  its  cancelli ;  that  a  fibrinous  exudate 
has  taken  its  place  ;  and  that  this  deposition  is  being  gradually 
replaced  by  osseous  material.     After  a  time,  the  open,  areolar 
appearance  of  the  interior  of  the  bone  assumes  that  of  compact 
tissue,  the  bone  at  the  same  time  increasing  in  weight.     This 
condition  may  continue  for  a  very  indefinite  period,  and  in  some 
cases  no  further  change  takes  place,  but  in  others  open  spaces 
are  formed  by  absorption  of  the  new  bone.     These  spaces  are 
small  at  first,  but  become  enlarged  by  removal  of  their  walls, 
and  by  the  coalescence  of  two  or  more  oi  them.     Thus  the  solid, 
compact  bone  again  becomes  cancellated,  but  this  cancellated 
structure  is  very  different  from  the   original;    for  the  bony 
trabeculse  are  now   deficient  in  animal  material,  are  mostly 
made  up  of  the  earthy  constituents  of  bone,  and  are  thus  brittle 
and  ready  to  break  upon  the  slightest  application  of  force.     The 
bones  most  liable  to  assume  this  condition  are  the  tarsal,  cunei- 
form, navicular,  and  pedal  bones ;  and  these  are  all  composed 
of  a  very  thin,  compact   shell,   and  much  cancellated  tissue. 
This  compact  layer  is  frequently  involved  in  the  diseased  pro- 
cess going  on  within,  and  covered  with  small  nodules  of  bone ;  at 
other  times  it  is  ulcerated  on  its  surface,  or  both  conditions  may 


FRAGILITUS  OSSIUM.  199 

be  co-existent.  The  pedal  bones,  however,  when  chronically 
inflamed,  become  absorbed  at  their  inferior  borders  externally, 
and  undergo  the  change  described  within  their  substance. 
iRew  formations,  as  bone-spavins  and  ring-bones,  when  of 
long  standing,  are  also  liable  to  take  on  this  action,  becoming 
brittle  and  easily  broken. 


OSTEO-SARCOMA. 

Spina  ventosa,  or,  as  it  is  called  by  Gamgee,  "  fibro-plastic 
degeneration  of  bone,"  is  a  disease  very  rarely  found,  except  in 
horned  cattle,  affecting  the  lower  jaws  generally;  but  in  one 
case  which  came  under  my  notice  the  upper  jaw  was  the  seat 
of  the  disease. — (See  Photo-lithograph,  Plate  lY.,  Fig.  7.)  These 
tumours  consist  of  an  osseous  crust,  forming  the  walls  of  a  cavity, 
divided  into  several  compartments  containing  a  reddish  fluid 
tubercular  material,  or  inspissated  pus  mixed  with  pieces  of  bony 
or  cartilaginous  substance,  bounded,  as  it  were,  by  cyst-like 
walls.  These  three  conditions  were  all  present  in  the  case  illus- 
trated, and  serve  to  form  three  definite  stages  of  the  disease: — 
Is^.  The  formation  of  a  cyst  containing  a  jelly-like  fluid;  2d. 
The  transformation  of  this  fluid  into  a  grey  caseous  material, 
which,  when  microscopically  examined,  presented  a  merely 
granular  appearance ;  and  M.  The  softening  of  the  tubercular 
matter  into  a  semi-fluid,  pus-like  substance,  mixed  with  pieces 
of  cartilage  and  bone. 

The  cause  of  this  disease  has  been  attributed  to  external 
violence ;  but  I  have  great  reason  to  doubt  the  accuracy  of  such 
a  conclusion,  and  I  am  of  opinion  that  the  causes  are  intrinsic, 
and  due  to  the  scrofulous  diathesis.  It  occurs  in  young  animals 
mostly,  and  is  said  to  affect  steers  more  than  bulls,  its  seat 
being  the  neighbourhood  of  the  second  and  third  molar  teeth, 
where  at  first  a  small  circumscribed  swelling  occurs.  When 
felt,  the  tumour  is  found  to  be  hot,  and  that  pressure  causes 
some  pain  to  the  animal.  At  first  the  animal  experiences  no 
inconvenience ;  indeed,  it  seems  to  suffer  but  little  throughout 
the  various  stages  of  the  disease,  provided  the  teeth  do  not 
become  carious,  when  of  course  the  sufferings  of  the  animal 
will  be  severe,  and  it  will  lose  flesh  from  inability  to  feed. 
The  bullock  from  which  the  drawing  was  obtained  was  quite  fat, 


200  NON-INFLAMMATORY  DISEASES  OF  BONES. 

and  sold  for  £29  the  day  before  he  was  slaughtered,  and  was  as 
able  to  masticate  his  food  as  if  nothing  ailed  him.  It  is  on 
record,  however,  that  the  teeth  drop  out  of  their  sockets,  and 
that  fistulse  open  into  the  mouth. 

Treatment,  in  any  but  the  early  stages,  is  out  of  the  question, 
and  the  only  thing  to  be  done  is  to  feed  the  animal,  if  possible, 
for  the  fat  market.  If,  however,  called  in  before  the  tumour 
has  attained  any  considerable  magnitude,  the  practitioner  may 
remove  it.  To  effect  this,  he  must  dissect  the  skin  and  sub- 
cutaneous structures  from  the  tumour;  trephine  in  one  or 
two  places,  as  starting-points;  and  remove  the  whole  of  the 
diseased  structures,  including  the  teeth  surrounded  by  them,  by 
either  the  bone  forceps  or  saw.  The  operator  must  be  careful 
not  to  leave  any  portion  of  the  diseased  parts,  or  it  will  most 
assuredly  become  the  nucleus  of  a  new  growth.  When  the 
removal  is  complete,  the  skin  is  to  be  brought  together  by 
metallic  or  carbolised  catgut  sutures,  and  over  all  collodion 
or  styptic  colloid  is  to  be  thickly  painted.  In  this  manner  the 
wound  will  often  heal  without  suppuration. 

The  practitioner  will  of  course  understand  the  necessity  of 
carefully  feeding  the  animal  upon  soft  diet  for  some  days  after 
the  operation,  and  that  some  attention  must  be  paid  to  the  parts 
operated  upon. 


THE  EFFECTS  OF  MERCURY  ON  BONE. 

The  accompanying  woodcuts — for  the  use  of  which  I  am  in- 
debted to  Professor  Bennett — illustrate  the  effects  of  mercury  on 
the  bones  of  a  dog,  the  skeleton  of  which  is  now  in  the  Museum  of 
the  University  of  Edinburgh.  The  history  of  the  case  is  given  by 
Professor  Bennett  in  his  Principles  and  Practice  of  Medicine, 
and  is  as  follows : — "  The  dog  lived  in  the  shop  of  Mr,  Ballan- 
tyne,  eighteen  years  ago,  in  Carrubber's  Close.  At  that  time 
the  work  carried  on  consisted  almost  exclusively  of  painting 
with  Vermillion  and  lacquering  Japan  articles.  The  dog,  who 
never  left  the  premises,  was  frequently  seen  lapping  the  Ver- 
million oil  paint ;  and  there  can  be  no  doubt  that  in  this  way 
there  was  introduced  into  his  system  a  considerable  quantity 
of  mercury.     After  death,  the  dog  was  dissected.     Numerous 


EFFECTS  OF  MERCURY  OX  BOXE. 


201 


cancerous-like  masses  were  found  in  the  lungs  and  internal 
viscera,  and  his  skeleton  was  preserved.  It  will  be  seen  that 
the  shafts  of  the  long  bones,   and  not  their  extremities,  were 


Fig.  33  —Skeleton  of  Dog. 


Tig.  34. 


Fig.  35. 
Figs.  34  and  35.— Two  views  of  the  Femur. 

attacked.  The  disease  closely  resembles  what  may  be  observed 
in  many  other  specimens  of  so-called  syphilitic  disease.  Yet 
in  this  dog  we  have  the  positive  proof  that  it  was  caused  by 
mercury,  as  all  attempts  to  communicate  the  syphilis  to  dogs  by 
inoculation  have  failed." 


DISEASES  OE  THE  JOINTS. 


EXPLANATION  OF  PHOTO -LITHOGRAPH,  PLATE  II. 

1.  Eheumatoid  Inflammation  of  Shoulder- Joint,  showing  por- 
cellaneous condition  of  articular  surface,  and  ossification  of  synovial 
fringes.     (1.)  Extremity  of  scapula.     (2.)  Upper  end  of  humerus. 

2.  Scrofulous  Disease  of  Elbow-Joint  of  Ox,  the  lower  ex- 
tremity of  humerus  being  shown.  (1.)  Tubercular  deposits  repre- 
sented by  the  white  spots.  (2.)  Destructive  absorption  of  the  cartilage 
and  bone. 

3.  Eheumatoid  Disease  of  Stifle- Joint,  showing — (1.)  Grooving 
of  the  bone,  and  the  porcellaneous  deposit;  and  (2.)  The  formation  of 
the  addimentary  bones  described  in  the  text. 

4.  Eemoval  of  Articular  Cartilage  and  Compact  Laminal 
Layers  from  the  surfaces  of  tibia  and  astragalus  in  a  case  of  open 
joint.  (1.)  New  ossific  deposit  external  to  the  articulation.  (2.)  Por- 
tion of  laminal  layer  not  yet  removed,  but  which  in  the  specimen  is 
"  tunnelled  under "  by  absorption.  (3.)  Lower  end  of  tibia;  which 
at  (4.)  contains  a  pit-like  ulcer. 

5.  HocK-JoiNT  IN  Eheumatoid  Bog-Spavin.  (1.)  Grooving  of  arti- 
cular surface  into  which  the  porcelain  is  deposited.  (2.)  Addimentary 
bones,  formed  by  ossification  of  the  synovial  fringes. 

6.  Fracture  of  Astragalus  and  Bone-Spavin.  (1.)  Astragalus. 
(2.)  Bone-spavin.     (3.)  and  (4.)  Metatarsal  bones. 

7.  Caries  op  the  Point  of  Os  Calcis  (Capped  Hock).  (L)  Sup- 
erior, and  (2.)  Inferior  extremities  of  the  bone. 

8.  Scrofulous  Inflammation  of  the  Phalangeal  Bones  op  Ox 
in  "  Eoul  in  the  foot.  (1.)  and  (2.)  Show  the  contrast  between  an 
ulcerated  and  healthy  articulation.  It  avlU  be  noticed  that  although 
the  destructive  process  is  much  advanced,  there  is  but  little  or  no 
attempt  at  repair  by  external  deposition  of  bone, 

9.  Tubercular  or  Scrofulous  Inflammation  of  the  Foot  op 
A  Cow,  commonly  called  "  foul."  At  (1.)  and  (2.)  are  weU-marked 
collections  of  "  yellow  tubercle."  . 


PLATER 


2fiime^s  f  Cempar^.£olvt^ 


CHAPTER  XL 

DISEASES  OF  THE  JOINTS. 

CLASSIFICATION    OF    THE    JOINTS ANCHYLOSIS    OF    THE   VERTEBRA 

ACUTE  SYNOVITIS CHRONIC  SCROFULOUS  SYNOVITIS — CALCIFICA- 
TION OF  THE  SYNOVIAL  FRINGES — RHEUMATOID  ARTHRITIS — 
MORBID  CONDITION  OF  CARTILAGE — TRAUMATIC  INFLAMMATION 
OF  THE  JOINTS IIYDROPS-ARTICULORUM ANCHYLOSIS. 

Joints  are  complex  in  their  structure,  consisting  of  bones,  arti- 
cular cartilage  which  covers  their  extremities,  synovial  mem- 
brane, capsular  and  binding  ligaments,  fat,  blood-vessels,  and 
nerves.  Owing  to  these  various  component  parts  possessing 
different  degrees  of  organization  and  vitality,  it  will  be  easily 
understood  that  the  diseases  of  the  joints  are  both  numerous  and 
important,  more  especially  when  the  extensive  motion  they  are 
called  upon  to  perform  is  taken  into  consideration. 

The  joints  are  divided  into  three  classes,  namely,  the  immove- 
able, the  moveable,  and  the  mixed.  The  immoveable  joints,  or 
sutures,  are  those  connecting  flat  bones  together,  as  in  the  bones 
of  the  head,  and  are  subject  to  no  special  diseases ;  it  is  there- 
fore with  only  the  two  latter  classes  that  we  have  to  deal. 

In  the  mixed  joints  the  ends  of  the  bones  are  not  covered  hy 
cartilage  of  incrustation,  nor  is  .there  a  true  articular  cavity 
lubricated  by  synovia ;  the  bones,  joined  together  by  powerful 
binding  ligaments,  are  yet  separated  from  each  other  by  a  thick 
broad  pad  or  disc  of  fibro-cartilage.  This  simple  kind  of  articu- 
lation is  subject  to  but  one  form  of  disease,  namely,  chronic 
inflammation,  causing  the  gradual  conversion  of  the  fibro-carti- 
laginous  pad  into  bony  tissue.  In  this  manner  the  vertebral 
column,  which  is  extremely  elastic  and  mobile  in  its  entirety,  is 
converted,  more  especially  in  the  lumbar  and  dorsal  regions, 
into  a  stiff,  unyielding  structure,  rendering  the  movements  of 


204  DISEASES  OF  THE  JOINTS. 

the  horse  uneasy  to  its  rider,  and  destroying  that  motion  of 
adaptability  wliich  is  pre-eminently  characteristic  of  that  ani- 
mal, and  which  enables  it  to  perform  an  amount  of  speed  with 
a  weight  upon  the  back  that  would,  without  this  provision,  be 
sufficient  to  cause  by  its  concussion  such  injury  to  its  internal 
economy  as  to  produce  disease,  and  even  death. 

Causes. — This  disease  is  generally  produced  by  the  animal 
being  compelled  to  bear  a  weight  disproportionate  to  its 
strength.  In  some  cases,  however,  it  proceeds  from  no  external 
appreciable  cause ;  it  must  therefore  arise  from  a  constitutional 
diathesis;  the  bones  becoming  fragile,  fatty,  and  degenerate 
in  condition,  liable  to  fracture  from  trivial  causes,  such  as  the 
moderate  contraction  of  the  muscles  attached  to  them,  or  even 
to  be  spontaneously  broken.  (See  Photo-lithograph,  Plate  IV., 
Fig.l.) 

The  specimen  from  which  this  plate  is  taken  beautifully 
illustrates  this  peculiar  pathological  condition.  When  newly 
prepared,  and  up  to  the  present  time,  it  is  found  to  resemble,  in 
its  external  appearance,  an  old  fossil  bone  of  a  dirty  rusty-brown 
colour,  greasy  to  the  touch,  and  crumbling  under  moderate  pres- 
sure. Microscopically  examined,  it  presented  numerous  oil 
globules,  its  bone  corpuscles  much  altered  in  shape,  and  in 
many  of  their  special  characteristics.  It  will  be  seen  that  an 
old-standing  fracture  exists,  and  that  a  process  of  repair,  repre- 
sented by  the  enlargement,  with  a  fissure  running  through  its 
whole  thickness,  had  gone  on  to  a  considerable  extent.  The 
animal  from  which  the  specimen  was  taken  presented  no  symp- 
toms of  having  its  back  in  this  condition,  nor  of  the  fracture 
during  life.  He  was  a  very  old  pony,  and  was  accidentally 
bought  for  dissection.  The  whole  of  his  spinal  column,  from 
the  sacrum  to  the  middle  of  tlie  cervical  region,  was  more  or  less 
affected ;  the  anchylosis  being  complete  between  all  the  lumbar 
and  dorsal  vertebrae,  but  only  in  the  rudimentary  state  in  those 
of  the  cervical  region.  Had  this  animal  been  cast  for  an  opera- 
tion, the  result  would  inevitably  have  been  a  broken  back,  no 
matter  how  carefully  such  casting  had  been  performed.  Veteri- 
narians will  bear  this  in  mind,  and  are  here  exhorted  to  make  a 
careful  2^ost  mortem  examination  of  every  case  of  such  an  acci- 
dent, not  only  as  to  the  mere  presence  of  the  fracture,  but  into 
the  pathological  condition  of  the  bones. 


ANCHYLOSIS  OF  THE  VERTEBRAE.  205 

The  symptoms  of  this  disease  are  very  obscure ;  some  slight 
stiffness  about  the  loins  may  be  observable  ;  disinclination  on  the 
part  of  the  horse  to  lie  down  in  the  stable,  more  or  less  clonic 
spasm  of  the  lumbar  and  gluteal  muscles  (shivering),  or  some 
degree  of  stringhalt. 

Cart-horses  are  more  subject  to  this  disease  than  any  other 
class  of  our  patients,  and  this  is  explained  by  the  fact  that  they 
are  loaded  with  heavy  weights  during  the  period  of  their  growth, 
when  their  age  and  strength  are  not  calculated  to  bear  them. 
"When  hunters  and  hacks,  as  age  advances,  become  stilty  in 
their  action,  unpleasant  to  ride,  the  change  is  often  as  much  due 
to  this  increased  stiffness  in  the  back  as  to  that  in  the  joints  of 
the  extremities. 

Sometimes  horses  suspected  to  be  suffering  from  this  disease 
present  symptoms  of  its  temporary  aggravation  by  a  greater 
degree  of  immobility  in  the  loins  and  back,  a  greater  extent  of 
the  spasmodic  action  before  referred  to,  and  by  signs  of  partial 
paralysis ;  there  will  be  reeling  of  the  gait,  crossing  and  draw- 
ing inwards  of  the  hind  feet,  inability,  without  danger  of  falling, 
to  turn  round  quickly,  great  difficulty  in  backing,  during  which 
process  a  peculiarly  sudden  quivering  elevation  of  the  tail  may 
often  be  observed. 

The  meninges  of  the  cord  are  in  such  cases  more  or  less  in- 
volved in  the  inflammatory  action. 

This  aggravation  may  be  produced  by  a  slight  cold,  indiges- 
tion, or  other  trivial  external  or  internal  cause. 

For  the  original  disease  nothing  can  be  recommended  except 
the  removal  of  its  cause,  if  possible,  and  a  period  of  rest ;  but 
for  the  exacerbations  active  treatment  is  required.  The  con- 
stitutional treatment  will  depend  upon  the  cause.  As  a  rule, 
a  purgative — if  its  administration  is  not  contra-indicated  by  the 
presence  of  a  catarrhal  affection  or  chest  disease — should  be 
given,  and  belladonna  in  moderate  doses,  in  preference  to  any 
other  sedative,  because  of  its  special  effect  upon  the  cord,  and 
its  power  of  diminishing  muscular  contractility.  The  local  treat- 
ment to  consist  of  fomentations  to  the  loins,  or  a  sheep-skin,  and 
the  application  of  gently  stimulating  embrocations. 

If  these  do  not  succeed,  a  blister  may  be  applied  with  advan- 
tage. If  the  hair  be  clipped  for  a  space  four  inches  broad,  and 
twelve  to  sixteen  inches  long,  upon  both  sides  of  the  spine,  the 


206  DISEASES  OF  THE  JOINTS. 

hair  around  its  borders  well  saturated  with  grease,  and  the 
blister  carefully  applied  to  the  clipped  patch  only,  no  danger 
may  be  apprehended.  It  should,  however,  be  washed  off  at  the 
end  of  twenty-four  hours. 

The  diathrodial  or  true  joints  are  divided  into  three  varieties, 
namely,  arthrodia  or  gliding  joints,  the  enarthrodia,  and  the 
ginglymoid. 

The  arthrodia  are  liable  to  inflammation,  and  ulceration  of  the 
articular  surfaces,  arising  primarily  in  the  bones  entering  into 
their  conformation. 

The  enarthrodia,  or  ball-and-socket  joints,  are  in  our  patients 
seldom  diseased,  and  generally  the  cause  of  such  disease  arises 
intrinsically,  such  as  from  the  rheumatoid  or  the  tubercular 
diathesis.  They  are  clothed  by  muscular  tissue,  and  but  rarely 
suffer  from  accidents. 

The  ginglymoid  or  hinged  joints  are  exposed  to  injuries  from 
without,  such  as  sprains  and  punctures,  which  are  productive  of 
a  variety  of  diseases,  namely,  inflammation  of  the  synovial  mem- 
brane (acute  and  chronic),  destruction  of  the  articular  cartilage, 
caries  of  the  extremities  of  the  bones,  a  deposition  of  calcareous 
matter  in  their  structure,  called  the  porcellaneous  deposit,  loose 
bodies  in  the  synovial  cavity,  defective  secretion  of  synovia,  in- 
creased secretion  of  it,  constituting  dropsy  of  the  articulation, 
and  anchylosis ;  these  are  also  liable  to  be  accidentally  opened. 

When  inflammation  of  a  joint  arises  from  a  strain,  the  liga- 
ments are  not  only  stretched,  but  are  more  or  less  lacerated  at 
their  points  of  attachment.  These  ligaments,  it  will  be  re- 
membered are  lined  upon  their  unattached  internal  surfaces 
by  synovial  membrane,  which  becomes  inflamed  when  they  are 
strained,  and  from  these  points  the  inflammation  extends  along 
the  whole  synovial  surface  of  the  articulation. 

The  true  hock-joint,  namely,  that  constituted  by  the  tibia 
and  astragalus,  may  be  taken  as  a  type  in  our  description  of 
these  various  forms  of  pathological  changes. 


INFLMIIVIATION  OF  THE  SYNOVIAL  MEMBRANE,  OR 
ACUTE  SYNOVITIS. 

The  primary  effects  of  inflammation  upon  this  membrane  are 
more  or  less  injection  of  the  vessels,  opacity,  and  dulness  of  its 


ACUTE  SYNOVITIS  207 

surface.  In  some  cases  it  will  be  of  an  extremely  dark  red 
colour,  owing  to  congestion,  and  may  present  an  appearance  of 
brownish  or  even  crimson  spots. 

At  the  outset  of  the  congestion,  this,  like  all  other  secreting 
membranes,  is  preternaturally  dry  upon  its  surface,  owing  to 
its  secreting  powers  being  for  a  time  in  abeyance ;  but  very 
shortly  there  will  be  a  superalmndant  secretion  of  an  unhealthy 
synovia,  aqueous  in  its  character,  and  containing  flakes  of  lymph. 
The  membrane  becomes  thickened  by  interstitial  deposition;  loses 
its  translucency,  and  becomes  rough  on  its  internal  surface,  to 
which  flakes  of  lymph  are  found  adherent.  This  exudation  of 
lymph  is  confined  to  the  synovial  surface,  and  does  not  extend 
to  the  articular  cartilage.  In  severe  cases  suppuration  may 
occur,  and,  if  the  disease  cannot  be  arrested,  ulceration  of  the 
cartilage  is  sure  to  follow. 

The  synovial  fringes  will  be  found  to  be  in  a  higher  state  of 
inflammation  than  any  other  portion  of  the  membrane. 

Any  true  joint  in  the  body  may  suffer  from  inflammation  of 
its  synovial  membrane,  but  some  are  more  liable  than  others. 
This  will  be  afterwards  referred  to  under  the  head  of  Lame- 
ness. 

The  causes  are  strains,  punctures,  the  localisation  of  rheumatic 
poison,  the  deposition  of  tubercular  matter  into  the  substance,  and 
upon  the  surface  of  the  synovial  membrane,  as  in  the  "  grapes"  of 
horned  cattle,  and  from  the  deposition  in  and  around  the  joints 
of  mineral  poisons,  as  seen  in  horses  which  are  employed  in  and 
about  large  smelting  works. 

The  symptoms  are  lameness  and  fever,  varying  in  their  degree 
according  to  the  severity  of  the  articular  inflammation.  If  the 
disease  be  severe,  the  pain  acute,  the  fever  will  be  high,  the  pulse 
quick  and  irritable,  partial  sweats  bedew  the  body,  but  more 
especially  the  affected  limb,  and  the  lameness  wiU  be  so  great 
that  the  animal  cannot  put  its  foot  to  the  ground.  The  affected 
joint  soon  commences  to  swell ;  the  swelling  being  tense,  yet 
elastic,  in  the  first  stages  ;  but  soon  becoming  hard,  firm,  and 
unyielding,  from  an  exudation  into  the  subcutaneous  structures. 
There  will  be  increased  heat  of  the  parts,  and  they  will  be 
tender  to  the  touch. 

It  is  of  the  utmost  consequence  to  arrest  the  disease  before 
the  cartilage  becomes  involved,  ov   it  will  be  incurable;    and 


208  DISEASES  OF  THE  JOINTS. 

if  it  be  in  one  of  the  posterior  articulations,  such  as  the  hock, 
it  is  often  necessary  to  place  the  animal  in  slings.  Fomenta- 
tions of  warm  water  must  be  applied  to  the  part  repeatedly, 
and  some  soothing  application  rubbed  on,  such  as  a  weak 
solution  of  opium  or  aconite.  The  shoe  must  be  removed ; 
but  if  the  practitioner  thinks  that  the  patient  will  be  able  to 
rest  better  with  a  high-heeled  shoe,  it  should  be  immediately 
applied. 

The  constitutional  treatment  will  depend  upon  the  severity 
of  the  symptoms.  In  all  cases  a  moderately  strong  purgative  is 
beneficial ;  and  if  the  pain  be  very  great,  opium,  two  or  three 
times  a  day,  will  best  relieve  it ;  care  being  taken  that  the  bowels 
do  not  become  constipated.  When  the  pain  is  less  acute,  aconite 
may  be  used  in  preference  to  the  opium. 

If  these  remedies  fail  to  give  relief  in  the  course  of  three  or 
four  days,  a  blister  must  be  applied.  No  bad  results  need  be 
feared  from  such  an  application.  In  many  cases  the  pain  will 
subside  and  the  fever  abate  in  the  course  of  a  few  hours  after 
the  blister  has  commenced  to  act. 

If  any  lameness  and  thickening  of  the  joint  threaten  to 
remain,  it  may  be  necessary  to  apply  the  actual  cautery. 

In  conclusion,  it  must  be  borne  in  mind  that  absolute  repose 
of  the  part  affected,  if  such  a  thing  were  possible  in  our  prac- 
tice, must  be  the  first  and  greatest  consideration  in  the  treat- 
ment of  the  disease. 


CHRONIC  SCROFULOUS  SYNOVITIS. 

(See  Photo-lithograph,  Plate  II.,  Fig.  2.) 

This  affection  is,  within  my  experience,  confined  to  horned 
cattle,  where  the  process  of  "  in-and-in"  breeding  has  been 
carried  out  to  too  great  an  extent.  The  joints  most  usually 
affected  are  the  elbow  and  stifle,  and  the  foot-joints  in  the 
disease  called  "  foul  in  the  foot."  It  attacks  animals  of  all  ages, 
but  generally  they  are  three  years  old  and  upwards. 

At  the  outset,  it  is  difficult  of  diagnosis,  the  symptoms  being  a 
lameness  arising  from  no  apparent  cause,  without  swelling,  or 
any  indication  of  pain  other  than  the  lameness ;  but  after  a  time 
a  slight  swelling  may  appear,  about  the  joint  affected,  without 


CHRONIC  SCROFULOUS  SYNOVITIS.  209 

mucli  heat,  or  pain  upon  pressure.  The  swelling  gradually 
enlarges,  and  is  of  a  doughy,  elastic  nature ;  the  limb  below  it 
seems  to  waste  ;  the  animal  begins  to  lose  condition  ;  the  lame- 
ness and  pain  increase ;  and  suppuration  may  take  place ;  but 
this  is  by  no  means  a  uniform  result. 

In  some  cases  constitutional  symptoms  of  scrofula  may  pre- 
cede the  manifestation  of  the  joint  disease;  when  this  is  the 
case,  the  diagnosis  will  be  rendered  easy,  and  the  practitioner 
need  not  hesitate  to  condemn  the  animal  to  slaughter. 

Pathological  Anatomy. — The  structures  around  the  joint  will 
be  found  infiltrated  in  circumscribed  spots  with  a  yellowash- 
white,  caseous,  solid  material  (tubercle),  and  the  synovial  mem- 
brane studded  upon  its  surface  with  yellowish-white  globular 
bodies,  which,  when  cut  into,  present  the  same  tubercular  charac- 
ter. These  bodies  vary  from  the  size  of  a  turnip  seed  to  that  of 
a  large  pea. 

The  membrane  itself  is  found  of  a  greyish- white  colour,  and 
gelatinous  in  appearance,  with  its  vessels  in  some  parts  highly 
injected;  the  synovial  fluid  curdy,  and  more  opaque  than 
natural ;  the  cartilages  of  incrustation,  as  w^ell  as  the  ends  of  the 
bones  removed  by  ulceration,  causing  the  interior  of  the  joint  to 
present  a  worm-eaten  appearance.  In  the  interior  of  the  bones, 
round  spots  of  tubercular  matter  are  seen  in  the  cancelli. 

In  dissecting  the  various  structures,  it  will  be  found  that  the 
skin,  the  subcutaneous  tissues,  and  synovial  membrane  are  matted 
together  into  an  almost  inseparable  mass. 

Tlie  causes  are,  as  already  indicated,  constitutional,  and  when- 
ever scrofula  in  any  of  its  forms  makes  its  appearance  in  a  herd,  it 
will  be  high  time  to  infuse  new  blood  into  it.  Exceptional  cases 
may,  however,  arise  from  neglect  or  other  debilitating  influence. 

The  treatment  can  be  but  palliative ;  the  preparation  of  the 
animal  for  the  butcher  being  the  only  end  to  be  gained.  The 
application  of  blisters  to  the  part  will  often  remove  the  inflamma- 
tion for  a  brief  period,  and  thus  allow  the  animal  to  put  on  fat. 

The  patient  must  be  stall-fed,  kept  as  quiet  as  possible ;  to 
have  food  of  the  most  fattening  nature;  cod-liver  oil  may  be 
given  night  and  morning.  If  the  disease  has  made  much  pro- 
gxess  before  the  practitioner  is  called  in,  or  if,  in  spite  of  the 
treatment  recommended,  it  continue  to  advance,  the  animal  had 
better  be  put  out  of  its  suffering. 

P 


210  DISEASES  OF  THE  JOINTS. 


CALCIFICATION  OF  THE  SYNOVIAL  FRINGES. 

In  the  dissection  of  old  horses  which  have  been  stiff  in  their 
joints,  the  synovial  fringes  are  often  found  in  a  state  of  calcifica- 
tion, the  ossific  or  calcareous  deposits  varying  from  the  size  of  a 
millet  seed  to  that  of  a  small  bean.  These  occasionally  become 
detached,  and  find  their  way  into  the  interior  of  the  articulation, 
causing  sudden  and  violent  lameness,  which  disappears  as  sud- 
denly as  it  came,  by  the  detached  body  regaining  its  original 
position.  A  condition  similar  to  this  has  been  termed  fimbriated 
synovial  membrane  by  pathologists. 

RHEUMATOID  ARTHRITIS. 

The  condition  of  the  synovial  membrane  described  in  the  last 
paragraph  is  probably  due  to  a  peculiar  inflammation,  which  has 
been  termed  rheumatic  gout  or  chronic  rheumatic  arthritis — a 
disease  differing  from  gout  and  rheumatism  in  many  particulars, 
although  possessing  some  characteristics  common  to  both.  This 
affection  in  man  has  been  studied  and  described  by  Dr.  Hay- 
garth  of  Bath,  by  Cruveilhier,  and  more  particularly  by  Dr. 
Adams  of  Dublin.  ^  By  Dr.  Haygarth  it  was  called  "  nodosity 
of  the  joints;"  and  by  Cruveilhier,  " usure  des  cartilages  articu- 
laires.'[  To  both  of  these  terms  Dr.  Adams  takes  exception, 
and  says — "  The  term  suggested  by  Cruveilhier,  it  is  plain, 
would  localise  the  disease  too  much,  confining  it  merely  to  one 
of  the  articular  textures ;  whereas  we  know  that,  when  fully 
formed,  most,  if  not  all,  of  these  textures  are  implicated ;  and 
as  to  the  term  '  nodositij  of  the  joints,'  the  swellings  of  the 
joints  which  we  notice  in  this  disease  are  by  no  means  hard,  as 
the  term  nodosity  would  imply.  On  the  contrary,  as  in  its 
early  stages  the  swellings  are  principally  constituted  by  the 
effusion  of  much  synovial  fluid  into  the  interior  of  the  joint, 
they  are  soft  and  fluctuating." 

I  am  sure  that  every  veterinary  surgeon  of  experience,  when 
he  has  read  the  following  account,  abbreviated  from  Dr.  Adams' 
work,  will  at  once  see  the  great  resemblance  it  bears  to  many 
cases  he  has  met  with  in  his  practice. 

The  disease  may  be  a  constitutional  or  a  local  disorder;  the 

^  A  Treatise  on  Rheumatic  Gout,  or  Chronic  Rheumatic  Arthritis,  all  of  the  Joints. 


EHEUMATOID  ARTHRITIS,  211 

constitutional  originating  in  sedentary  pursuits,  sudden  exposure 
to  cold  when  the  body  has  been  over-heated,  or  as  a  sequel  to 
rheumatic  fever ;  the  local,  from  habitual  over-exertion  of  a  par- 
ticular joint,  or  from  accident. 

Bymidtoms. — A  singular  rigidity  in  the  affected  joints,  which, 
when  first  moved,  emit  a  crackling  sound.  The  crackling  sen- 
sation, felt  as  well  as  heard  in  the  human  patient,  and  the 
rigidity  of  the  limbs,  followed  by  pains,  are  very  considerable  at 
the  moment  the  patient  commences  to  move  about,  particularly 
in  the  morning,  after  the  repose  of  the  night ;  and  in  some  cases 
there  are  painful  spasms  of  the  muscles. 

The  veterinarian  frequently  finds  both  these  symptoms,  namely, 
the  crackling  noise  and  the  painful  and  spasmodic  uplifting  of 
the  limbs,  especially  the  hind  ones,  in  many  of  his  patients, 
whose  joints  present  the  other  symptoms  of  the  disease  in  man 
— the  swelling,  pain,  and  tenderness  to  the  touch. 

The  swelling  in  and  around  the  affected  joints,  which  is 
noticed  in  the  earlier  stages  of  the  disease,  arises  principally 
from  the  increased  effusion  into  the  synovial  sacs  of  the  articu- 
lation, a  result  of  the  chronic  synovitis  which  at  this  period 
exists.  In  the  later  stages  of  the  affection,  exostotic  growths 
can  be  occasionally  felt  through  the  integuments. — (See  Photo- 
lithograph,  Plate  II.,  Figs.  1,  3,  and  5.)  These  spring  from  the 
margins  of  the  articular  surfaces,  as  well  as  from  the  periosteum 
and  bone  in  the  neighbourhood  of  the  diseased  joint.  In  the 
tibio-femoral  articulation  (stifle-joint)  rims  of  new  bones  can  be 
seen  to  range  themselves  along  the  margin  of  the  condyles  of 
the  femur  and  tibia. — (See  particularly  Fig.  3  in  the  same 
plate.) 

Articular  rigidity,  or  false  anchylosis,  is  not  an  unusual  con- 
sequence of  the  disease ;  but  true  anchylosis,  or  the  complete 
fusion  together  of  two  bones,  is  exceedingly  rare ;  nor  does  the 
disease  in  its  ordinary  course  proceed  to  suppuration. 

The  synovial  bursse  in  the  neighbourhood  of  the  affected  joint 
are  occasionally  found  distended,  and  synovial  cysts  become,  as 
it  were  accidentally,  developed  in  the  areolar  tissue  surroimding 
the  affected  articulation,  having  no  communication  with  the 
diseased  joint.  As  the  dieease  advances,  the  fluid  contained 
in  these  cysts  may  become  absorbed,  and  the  sacs  converted  into 
solid  tumours. 


212  DISEASES  OF  THE  JOINTS. 

Anatomical  character  of  the  Disease. — The  capsules  of  the 
joint  are  thickened,  and  at  the  same  time  distended  with  a 
large  quantity  of  synovial  fluid.  At  a  later  stage  the  fluid 
is  removed  by  absorption,  and  the  capsular  membranes  acquire 
a  preternatural  density.  Some  of  the  normal  structures,  as  the 
round  ligament  in  the  hip,  and  the  semi-lunar  cartilages  in 
the  stifle-joint,  are  completely  absorbed,  if  the  joint  has  been 
long  and  severely  affected.  The  lateral  ligaments  of  the 
ginglymoid  joints  become  preternaturally  elongated,  and  new 
growths,  varying  in  consistence — some  being  cartilaginous 
throughout,  others  bony  in  their  centres  and  cartilaginous 
at  their  circumference — are  found  in  and  around  the  affected 
joints.  These  are  first  developed  in  the  synovial  membrane, 
and  are  almost  always  attached  to  it  by  a  slender  cord,  or 
by  a  broad  base ;  and  around  the  rim  of  the  cotyloid  and 
glenoid  cavities  additional  foreign  bodies — called  by  Adams 
"addimentary  bones" — are  usually  found  deepening  and  en- 
larging the  "  cavities  of  reception"  for  the  heads  and  condyles 
of  bones  composing  the  articulations. — (See  Photo-lithograph, 
Plate  I.,  Fig.  2.)  The  articular  cartilages  are  removed,  and 
their  place  supplied  by  an  ivory- like  enamel^ — the  porcel- 
laneous deposit — in  the  hip  and  shoulder  joints,  the  surfaces 
of  the  bones  become  as  smooth,  in  whole  or  in  part,  as  an 
ivory  ball. —  (See  Photo-lithograph,  Plate  II.,  Pig.  1.)  In 
the  ginglymoid  joints  the  place  of  the  removed  cartilage  is 
supplied  by  means  of  patches  of  ivory  or  porcelain-like  enamel, 
marked  out  by  parallel  grooves,  hollowed  out  in  the  direction 
of  the  movements  of  extension  and  flexion. — (See  Photo- 
lithograph,  Plate  II.,  Pigs.  3  and  5.) 

I  think  that  I  have  produced  sufficient  evidence  from  the 
symptoms  during  life,  and  the  appearances  of  the  bones  after 
death,  to  prove  the  similarity,  if  not  the  identity,  of  this  dis- 
ease with  the  rheumatic  gout,  or  more  properly  the  rheumatoid 
affection  of  the  joints  of  the  human  being.  Wliat  veterinary 
surgeon  can  have  failed  to  notice  the  peculiar  stiffness  of  the 
limbs,  and  the  crackling  noise  emitted  when  the  joints  are 
moved  in  some  cases  of  bog-spavin  and  navicular  lameness  ? 
And  no  one,  I  am  sure,  is  prepared  to  deny  that  the  peculiar 
alterations  of  structure  and  the  intractable  nature  of  the 
morbid  processes  are  not  due  to  a  diathesis  or  constitutional 


RHEUMATOID  ARTHRITIS.  213 

condition  similar  to   that  which   in  man   predisposes  to  this 
malady. 

In  support  of  this  view  of  the  pathology  of  this  disease,  I  take 
the  liberty  of  quoting  some  remarks  made  by  Dr.  G.  W.  BaKour 
of  Edinburgh  in  a  clinical  lecture  published  in  the  Edinburgh 
Medical  Journal,  February  1870,  page  713.  He  says — "You 
may  remember,  at  the  close  of  my  last  lecture,  that  I  exhibited 
to  you  the  bones  of  a  horse  affected  with  rheumatoid  arthritis. 
The  case  to  which  I  then  referred  is  still  under  treatment, 
though  improved ;  and  I  purpose  referring  now  more  at  large  to 
the  subject.  I  brought  these  horse  bones  the  other  day  for 
several  distinct  reasons : — 1st.  To  show  you  well-marked  ex- 
amples of  eburnation  on  a  larger  scale  than  we  ever  have  them 
in  human  joints ;  2d.  To  show  you  that  this  eburnation,  in  the 
horse  at  least,  is  not  confined  to  the  surface  of  the  bone — is  not 
therefore  produced,  as  has  been  supposed,  by  mere  consolidation 
and  polishing  produced  by  friction,  as  you  would  polish  a  piece 
of  hard  wood  or  dead  bone ;  for  you  remember,  in  the  one  bone, 
the  OS  naviculare — a  sesamoid  bone,  not  exposed  to  friction  or 
pressure  at  all — this  eburnation  had  extended  throughout  the 
whole  substance  of  the  bone,  showing  that  probably  the  process 
is  an  integral  part  of  the  disease,  and  does  not  depend  on  friction 
at  all, — as,  indeed,  in  living  bones  we  could  scarcely  expect 
would  be  the  case ;  and  Zd.  To  show  that  horses,  who  live  so 
very  differently  from  man,  both  as  regards  food  and  drink,  and 
who  never  have  gout,  are  yet  commonly  affected  by  a  disease 
which  produces  precisely  the  same  pathological  results  as  rheu- 
matoid arthritis  in  man,  thus  affording  additional  proof  that 
rheumatoid  arthritis  has  nothing  gouty  in  its  nature;  and 
showing  that,  to  obtain  anything  like  a  proper  and  profitable 
pathological  history  of  this  disease,  we  must  include  the  lower 
animals  in  our  survey.  As  yet  very  little  is  known  of  rheuma- 
toid arthritis,  and  yet  it  is  of  importance  to  know  that  little ; 
because  it  is  of  the  utmost  consequence  to  recognise  both  the 
acute  and  chronic  disease,  the  treatment  being  so  dissimilar 
from  that  of  the  diseases  with  which  they  are  apt  to  be  con- 
founded— chiefly  rheumatism  and  gout — but  which  may  also  in 
the  early  stages  include  locomotor  ataxy  and  Bright's  disease,  both 
of  which  are  frequently  associated  with  pains  which  might  be 
mistaken  for  those  of  rheumatoid  arthritis,  an  old  disease,  long 


214  DISEASES  OF  THE  JOINTS. 

known  by  those  skilled,  but  little  recognised  generally  by  the 

profession Eheumatoid  arthritis  appears  to  be  a 

disease  arising  from  exposure  to  cold  and  damp,  but  only  in  a 
person  constitutionally  predisposed  by  debility  from  some  cause 
or  other.  But,  truly,  we  know  nothing  certain  in  regard  to  this, 
and  we  require  to  have  our  knowledge  of  human  pathology  col- 
lated with  that  of  the  horse  before  we  can  form  any  rational 
theory  on  the  subject.  The  blood,  the  urine,  and  the  perspira- 
tion have  all  been  analysed  with  merely  negative  results,  and 
yet  the  morbid  anatomy  of  the  disease  is  perhaps  the  richest  and 
the  most  extraordinary  belonging  to  any  complaint,  the  disease 
affecting,  in  its  peculiar  way,  every  bone  and  every  joint  in  the 
body.  In  the  early  stage  of  the  disease,  there  is  found  simply 
effusion  of  synovia,  with  vascular  injections,  signs  of  arthritis ; 
at  a  later  stage  the  fluid  becomes  absorbed,  the  capsular  mem- 
brane thickened,  and  the  cartilage  ulcerated.  At  a  very  early 
period  this  cartilage  splits  up,  and  becomes  removed  apparently 
by  a  slow  process  of  absorption,  the  whole  surface  of  the  joint 
being  then  denuded,  the  osseous  surface  becoming  polished  and 
eburnated,  as  in  those  specimens." 

The  treatment  is  merely  palliative,  and  is  chiefly  constitu- 
tional. Alkalies  may  be  administered,  the  bowels  regulated  b} 
an  occasional  purgative,  the  animal  carefully  fed,  and  put  to 
slow  work ;  and  when  any  sudden  increase  of  lameness,  denot- 
ing a  fresh  attack,  occurs,  fomentations,  or  perhaps  moderate 
blisters,  are  to  be  prescribed. 


MORBID  CONDITION  OF  CAETILAGE. 

Articular  cartilage  becomes  diseased  in  consequence  of  syno- 
vitis, disease  of  the  bone  to  which  it  adheres,  or  independently 
of  any  morbid  condition  of  adjacent  structures,  and  such  disease 
may  commence  upon  its  free  or  its  attached  surface,  or  in  the 
middle  of  its  substance. 

In  violent  inflammation  of  joints,  as  those  arising  from  punc- 
ture, the  destruction  of  the  cartilage  is  accompanied,  or  even 
preceded,  by  the  destructive  absorption  of  the  vascular  extremity 
of  the  bone  immediately  contiguous  to  its  articular  laminal  layer. 
In  this  manner  we  can  explain  the  presence  of  floating  pieces  of 
cartilage  and  bone  in  the  synovial  fluid. 


MORBID  CONDITION  OF  CARTILAGE. 


215 


Cartilage  may  become  destroyed  from  disease  arising  within 
itself,  independently  of  any  morbid  condition  in  the  bones  or 
synovial  membrane ;  and  to  account  for  this,  seeing  that  carti- 
lage is  a  non-vascular  structure,  Goodsir,  Kedfern,  and  others 
made  many  important  investigations. 

The  anatomist  will  be  aware  that  cartilage  in  a  healthy  state, 
when  microscopically.,  examined,  is  seen  to  consist  of  a  homo- 
geneous matrix,  called  the  hyaline  substance,  with  nucleated 

cells,called  the  cartilage  corpus-     _ 

cles,  embedded  in  it's  substance, 
arranoed  in  a  certain  order. 
Cartilage  contains  no  blood- 
vessels, but  derives  its  nourish- 
ment by  imbibition  from  the 
surroundincf  fluids  and  textures. 
In  the  large  joints,  blood-vessels 
may  occasionally  be  seen  pene- 
trating the  cartilage,  but  these 
do  not  seem  to  form  nutrient 
loops  ;  hence,  to  all  intents  and 
purposes,  articular  cartilage 
contains  no  blood-vessels,  nor 
have  any  nerves  been  discovered  in  it;  consequently,  it  pos- 
sesses no  sensibility. 

It  was  first  demonstrated  by  Goodsir  that  ulceration  of 
cartilage  is  accompanied  by  enlargement  and  alteration  in  the 
form  and  arrangement  of  the  cells.  "  Instead  of  being  of  their 
usual  form,  they  are  larger,  rounded,  or  oviform,  and  instead  of 
two  or  three  nucleated  cells  in  their  interior,  contain  a  mass 
of  them.  At  the  very  edge  of  the  ulcerated  cartilage,  the 
cellular  contents  communicate  with  a  diseased  membrane  by 
openings  more  or  less  extended.  Some  of  the  ovoidal  masses 
in  the  enlarged  corpuscles  may  be  seen  half  released  from  their 
cavities  by  the  removal  of  the  cartilage."  ^  Goodsir  describes 
a  false  membrane  of  a  gelatinous  nature,  which  covers  the 
cartilage  during  the  progress  of  the  disease,  both  in  scrofulous 
and  simple  inflammation.  As  far  as  my  investigations  go,  I 
have  only  found  this  membrane  in  two  instances. 

The  texture  of  the  cartilage  does  not,  during  the  progress 

^  GooDSiR's  Anatomical  and  Pathological  Observations. 


Fig.   36. — Healthy  cartilage,  from  in- 
ferior surface  of  navicular  bone  of  horse. 


216 


DISEASES   OF  THE  JOINTS. 


of  the  ulceration,  exhibit  any  traces  of  vascularity,  and  the 
membrane,  which  was  supposed  by  Goodsir  to  be  the  cause  of 
the  ulceration,  is  regarded  as  the  result  of  the  disease.  The 
formation  of  this  false  membrane,  which  is  sometimes  on  the 
bone,  sometimes  on  the  attached  surface  of  the  cartilage,  has 
conveyed  the  erroneous  impression,  entertained  by  some  ob- 
servers, that  in  one  form  of  destruction  of  articular  cartilages, 
the  destruction  is  preceded  by  the  formation  of  vessels  in  the 
substance  of  the  cartilage  itself.  It  is  quite  certain  that  in 
nearly  all  instances  of  destruction  of  the  articular  cartilages, 
in  the  lower  animals  at  least,  there  have  been  extensive  ulcera- 
tions without  the  presence  of  any  vascular  membrane ;  and  in 
one  instance  that  fell  under  my  notice,  a  false  membrane  was 


^*         li;i>^-"^"   '^^^^L':^>■■>^'/^':S.■y:•:.rL■?^^^ 


-»-  l;.-:^ 


Fig.  3». 


Fig.  37. 

Fig.  37. — Diseased  articular  cartilage,  showing  the  enlargement  of  the  cor- 
puscles, the  increase  of  the  nuclei  within  them,  and  their  escape  into  the 
eoftened  matrix. — (Redfern.) 

Fig.  38. — Deepest  part  of  a  vertical  section  from  the  cuneiform  surface  of 
the  semi-lunar  bone,  showing  the  cells,  with  thickened  walls. — (Redfern.) 

found  covering  the  articular  surface  of  the  astragalus,  the 
cartilage  of  which  presented  no  signs  of  ulceration ;  whilst  the 
tibial  cartilage  of  the  same  joint  was  ulcerated  without  being 
covered  by  any  adventitious  membrane. 

The  further  changes  are  the  bursting  of  the  enlarged  cells 
at  the  surface  of  the  cartilage,  which  by  this  change  becomes 
disintegrated.  In  some  cases,  the  nuclei  which  have  escaped 
from  the  cells  become    elongated,  and  incorporated   with   the 


MORBID  CONDITION  OF  CARTILAGE. 


217 


hyaline  substance,  giving  it  unusual  softness,  and  causing  it  to 
swell,  fibriilate,  and  split  into  fibrous  bands  projecting  into  the 
joint.     In  other  cases,  the  nuclei  degenerate  into  fatty  material 


Fig.  39. 


r^^^mmmm 


Fig.  41. 

Fig.  39.— Cartilage  from  diseased  human  patella,  showing  on  the  surface 
fibrous  tissue  with  imbedded  cells  and  nuclei.  — (  Redfern.  )  This  figure  repre- 
sents very  exactly  the  commencement  of  the  fibrillation  and  splitting  up  of  the 
cartilage,  lining  the  inferior  surface  of  the  navicular  bone  in  navicular  disease, 
before  adhesion  has  taken  place,  betv/een  the  bone  and  tendon. 

Fig.  40  shows  a  more  complete  formation  of  bands  and  fibres  upon  the 
surface  of  the  cartilage. — (Redfekn.) 

Fig.  41.— Vertical  section  from  the  cartilage  of  the  central  part  of  the 
glenoid  cavity  of  the  (human)  tibia,  showing  the  splitting  into  fibres  on  the 
surface.- (Redfern.)  This  appearance  of  the  cartilage  represents  very  fairly 
the  condition  of  the  navicular  cartilage  when  the  bone  and  tendon  have  be- 
QQXxxe  adherent. 


218  DISEASES  OF  THE  JOINTS. 

within  the  cartilage  corpuscles.  Another  change  is  the  infiltra- 
tion of  the  cartilage  with  the  salts  of  lime,  this  change  com- 
mencing in  the  cell  wall.  This  may  often  be  seen  in  the 
cartilage  of  the  navicular  bone.  The  alteration  in  the  hyaline 
substance  consists  in  its  losing  its  glistening  appearance,  and 
being  split  up  into  shreds  of  fibres  projecting  into  the  joint. 

Dr.  Eedfern  has  arrived  at  the  following  conclusions  from  his 
inquiries  into  this  subject : — • 

1st.  That  all  the  known  forms  of  disease  in  articular  cartilage 
are  connected  w^ith  changes  in  the  texture,  which  are  essentially 
similar  to  each  other. 

2d.  That  during  the  progress  of  these  changes  the  cells  of  the 
cartilage  become  enlarged,  rounded,  and  filled  with  corpuscles, 
in  lieu  of  healthy  cells  ;  bursting  subsequently,  and  discharging 
tlie  contents  into  the  texture  on  the  surface ;  whilst  the  hyaline 
substance  splits  into  bands  and  fibres,  and  the  changed  hyaline 
substance,  and  the  discharged  corpuscles  of  the  cells  afterwards 
form,  in  many  cases,  a  fibro-nucleated  membrane  on  the  surface 
of  the  diseased  cartilage. 

3d.  That  these  changes  are  referable  only  to  an  abnormal 
nutrition  as  their  immediate  cause,  and  in  no  case  to  mechanical 
or  chemical  actions,  such  as  attrition,  or  digestion  in  a  diseased 
secretion. 

Ath.  That  most  extensive  disease  may  go  on  in  many  joints  at 
the  same  time,  and  may  proceed  to  destroy  the  whole  thickness 
of  the  cartilage  in  particular  parts,  without  the  patient's  know- 
ledge, and  while  he  is  engaged  in  active  occupation. 

5th.  That  the  disease  commences  most  frequently  on  the  free 
surface,  but  may  proceed  from  the  bone  to  affect  the  attached 
surface,  or  may  take  place  in  the  middle  of  the  thickness  of  the 
cartilage. 

6th.  That  it  is  at  least  very  doubtful  if  the  symptoms  whicli 
are  believed  to  indicate  the  existence  of  ulceration  of  articular 
cartilages  are  not  really  dependent  on  a  morbid  change  in  the 
bone. 

7th.  That  disease  of  the  whole  thickness  of  an  articular  carti- 
lage at  particular  parts  admits  of  a  natural  cure,  by  the  formation 
of  a  fibro-nucleated  membrane  from  the  substance  of  the  cartilage, 
without  the  occurrence  of  any  new  exudation. 

When  cartilage  is  destroyed,  it  is  never  reproduced.     If  the 


MORBID  CONDITION  OF  CARTILAGE.  219 

destruction  be  superficial,  the  breach  may  be  repaired  by  the 
formation  of  the  fibro-nucleated  membrane.  In  such  cases  the 
affected  part  will  present  a  velvety  appearance.  If  the  synovial 
membrane  be  involved,  the  fibro-nucleated  membrane  may  be 
incorporated  with  an  exudation  from  the  synovial  surface. 

Dr.  Eedfern,  in  his  researches  On  the  Healing  of  Wounds 
in  Articular  Cartilages,  has  satisfactorily  demonstrated  that  the 
repair  of  cartilage  is  always  a  very  slow  process.  In  one  experi- 
ment, in  which  he  had  made  three  incisions  into  the  cartilage  of 
a  patella,  and  two  into  that  of  the  trochlear  surface  of  the  femur 
of  a  dog,  he  found  that  no  union  had  taken  place  in  twenty-nine 
weeks,  but  a  reparative  process  had  just  commenced.  In  another 
case,  similar  incisions  were  firmly  united  by  fibrous  tissue  in 
twenty-four  weeks  and  five  days. 

The  appearance  of  the  parts,  upon  examination  by  Dr.  Eedfern 
at  the  end  of  this  time,  I  beg  to  give  in  his  own  words : — 

"  A  slightly  increased  quantity  of  synovia  exists  in  the  joint ; 
the  patella  rests  by  the  external  half  of  its  articular  surface  on 
the  inner  side  of  the  internal  condyle  of  the  femur,  and  the  part 
of  the  fibrous  capsule  of  the  joint  which  lies  upon  the  trochlear 
surface  of  the  femur,  and  glides  over  it,  presents  a  dense  wliite 
and  smooth  spot,  similar  in  appearance  to  fibro-cartilage,  and  of 
exactly  the  same  size  and  shape  as  the  trochlea.  The  edges  of 
the  trochlear  surface  of  the  femur,  and  the  vertical  ridge  on  the 
cartilage  of  the  patella,  are  less  prominent  than  usual,  and 
rounded.  The  cartilage  of  the  femur  appears  perfectly  healthy, 
and  that  of  the  tibia  somewhat  softer  than  natural,  and  the  car- 
tilage of  the  patella  is  more  transparent,  and  has  a  small  perfora- 
tion in  its  centre  leading  down  to  the  bone.  The  position  of  the 
incisions  is  difficult  to  see  on  the  patella,  and  is  only  marked  by 
the  slightest  curvilinear  depressions^;  on  the  femur,  one  incision 
is  recognised  with  the  greatest  difficulty,  and  the  position  of  the 
other  cannot  be  seen  with  the  naked  eye. 

"  On  microscopical  examination,  the  superficial  cells  over  a 
considerable  extent  of  the  surface  of  the  cartilage  of  the  patella, 
and  especially  in  the  neighbourhood  of  the  central  depression, 
have  become  much  enlarged,  many  measuring  xxiVir  of  an  inch 
in  diameter ;  they  are  nearly  spherical,  and  their  contents  appear 
to  have  divided  into  three  or  four  masses  like  nuclei ;  they  are 
lodged  in  hyaline  substance  of  greater  transparency  and  much 


220  DISEASES  OF  THE  JOINTS. 

greater  softness  than  ordinary,  so  that  the  cells  can  be  pressed 
out  of  it. 

"  In  the  neighbourhood  of  the  incisions  into  the  cartilage  of 
the  patella,  and  upon  the  trochlear  surface  of  the  femur,  though 
not  extending  upon  the  condyloid  surfaces,  the  substance  of 
the  superficial  layers  of  the  cartilage  has  become  converted 
into  a  membrane  composed  of  granules,  nuclei,  and  fibres. 
The  formation  of  this  membrane  may  readily  be  traced  by  an 
examination  of  it  at  the  line  of  junction  of  the  trochlear  and 
condyloid  surfaces,  where  it  becomes  thin  before  it  ceases  to  be 
observed.  The  contents  of  the  cells  first  become  granular,  and 
the  hyaline  substance  soft  and  more  transparent ;  the  walls  of 
the  cells  disappear  gradually,  and  scarcely  anything  but  cell 
membranes,  granules,  and  molecules,  lying  in  a  hyaline  mass, 
can  be  seen ;  fibres  are  then  formed  between  the  nuclei,  and  the 
latter  either  disappear  altogether  or  elongate  into  nuclear  fibres, 
and  thus  a  dense  fibrous  mass  is  produced.  If  during  this  pro- 
cess the  cells  have  become  larger  than  natural,  they  give  to  the 
junction  of  the  cartilage  and  membrane  a  notched  appearance, 
by  bursting  and  discharging  their  contents  into  the  latter ;  but 
if  no  enlargement  has  taken  place,  the  textures  run  into  each 
other  so  insensibly  that  no  distinct  line  of  demarcation  can  be 
drawn  between  them. 

"  The  portions  of  the  texture  through  which  incisions  were 
made  present  similar  appearances  in  every  instance.  Not  the 
slightest  difficulty  is  experienced  in  making  sections  through 
both  the  cut  surfaces  and  the  substance  by  which  they  are 
firmly  united.  Such  sections  show  the  cut  surfaces  to  be  very 
uneven,  and  hollowed  into  small  pits  of  the  size  of  the  cartilage 
cells  of  these  parts.  The  pits  are  obviously  produced  by  the 
half-destro3^ed  cells,  the  former  contents  of  which  are  now  seen 
lying  on  the  surface.  No  evident  change  has  taken  place  in 
the  texture  of  the  cartilage  at  a  little  distance  from  the  cut 
surfaces,  except  that  here  and  there  the  intercellular  substance 
presents  a  fibrous  appearance.  There  is  no  obvious  enlarge- 
ment of  the  cells,  or  crowding  of  their  interior  with  corpuscles, 
as  is  frequently  seen  to  occur  under  similar  circumstances. 
The  substance  uniting  the  cut  surfaces  consists  of  a  hyaline, 
granular,  and  indistinctly  striated  mass,  in  which  there  are 
numbers  of  rounded,  oblong,  elongating,  or  irregularly  shaped 


MORBID  CONDITION  OF  CARTILAGE. 


221 


corpuscles,  varying  in  size  from  -5o\,^  to  o^nnr  o^  ^^  i^cli 
in  diameter,  those  in  the  adjacent  cartilage  measuring  more 
uniformly  about  ^o^  of  an  inch.  The  corpuscles  are  more 
numerous  in  the  substance  connecting  the  cut  surfaces  than  in 
the  cartilao-e  itself,  and  the  intercellular  substance  of  the  same 
part  is  slightly  more  transparent  than  that  of  the  adjacent 
texture,  the  appearance  of  fibres  being  most  distinct  in  those 
parts  which  are  directly  in  contact  with  the  cartilaginous  sur- 
faces.— (Fig.  42.)  In  sections  obtained  from  the  cartilage  of 
tlie  femoral  trochlea  the  mass  between  the  cut  surfaces  is  less 
transparent,  its  fibres  are  much  more  perfect,  and  the  corpuscles 
are  smaller  and  less  easily  seen. — (Fig.  43.)  The  fibrous  and 
nucleated  membrane  formed  on  the  surface  of  the  cartilage  is 
continuous  with  the  uniting  medium,  and  differs  from  it  merely 
in  having  its  fibres  parallel  to  the  surface. 


Fig.  42. 


Fig.  43. 


Fig.  42.  — Vertical  section  of  the  cartilage  of  the  patella  of  a  dog  passing 
through  an  oblique  incision  made  twenty-four  weeks  and  five  days  before 
examination,  and  showing  perfect  and  firm  union  of  the  cut  surfaces. — 
(Redfern.  ) 

Fig.  43.  —Section  of  the  cartilage  of  the  femur  of  a  dog  passing  through 
an  oblique  incision  made  twenty -four  weeks  and  five  days  before  examina- 
tion, and  showing  the  perfect  fibrous  tissue  developed  in  the  healing  of  the 
wound. — (Redfern.  ) 

"  It  may  be  here  remarked,  that  tlie  lameness  which  occurred 
in  this  case  is  by  no  means  to  be  viewed  as  the  result  of  the 
injury  to  the  cartilages ;  for  except  when  dislocation,  or  some 
other  accidental  occurrence,  takes  place,  incisions  in  the  articu- 
lar cartilages  of  the  knee-joints  of  dogs  are  attended  with  no 
lameness  or  evidence  of  suffering  whatever,  after  the  first  few 
days,  which  are  required  for  the  healing  of  the  external  wound. 
Neither  is  it  to  be  supposed  that  articular  cartilages  are  in  a 
favourable  position  for  the  healing  of  wounds ;  for,  indepen- 
dently  of  the    continued   movement,   which  is  no  less  detri- 


222  DISEASES  OF  THE  JOINTS. 

mental  here  than  in  the  healing  of  ordinary  womids,  many- 
actions  which  take  place  in  these  textures  proceed  very  slowly, 
and  therefore  are  in  greater  danger  of  being  interfered  with 
in  their  progress.  In  an  instance  in  w^iich  I  made  three 
incisions  into  the  cartilage  of  the  patella,  and  two  into  that  of 
the  trochlear  surface  of  the  femur,  no  adhesion  had  taken  place 
in  any  of  the  instances  when  the  parts  were  examined  twenty- 
nine  weeks  afterwards,  though  no  inflammation  of  the  joint, 
dislocation,  lameness,  or  other  apparent  cause  for  the  want  of 
union  had  occurred.  Yet  some  of  the  cut  surfaces  were  in 
such  close  contact,  before  the  parts  were  examined  by  means 
of  sections,  as  to  lead  to  the  supposition  that  union  had  taken 
j)lace.  On  the  examination  of  these  wounds,  no  effused  matter 
of  any  kind  appeared  on  the  perfectly  smooth  cut  surfaces ; 
but  as  the  cells  near  to  them  in  the  substance  of  the  cartilasje 
were  obviously  enlarged  and  rounded,  having  in  their  interior 
three  or  four  corpuscles  into  which  their  nucleus  appeared  to 
have  divided,  or  a  number  of  bright  granules,  there  appears 
reason  to  believe  that  union  might  still  have  occurred  had  more 
time  been  allowed. 

"  After  the  fore^oinsj  observations,  I  no  loncjer  entertain  the 
slightest  doubt  that  wounds  in  articular  cartilages  are  capable  of 
perfect  union  by  the  formation  of  fibrous  tissue  out  of  the  texture 
of  the  cut  surfaces.  The  essential  parts  of  the  process  appear  to 
be  the  softening  of  the  intercellular  substance  of  the  cartilage, 
the  release  of  the  nuclei  of  its  cells,  the  formation  of  white 
fibrous  tissue  from  the  softened  intercellular  substance,  and  of 
nuclear  fibres,  by  the  elongation  of  the  free  nuclei.  It  does  not 
appear  necessary  that  the  cells  should  become  much  enlarged 
or  crowded  with  corpuscles,  for  the  union  may  take  place  with- 
out any  enlargement  of  the  cells,  or  increase  in  the  number  of 
their  corpuscular  contents  ;  these  changes,  therefore,  though  they 
contribute  materially  in  some  cases  to  the  raj)idity  of  completion 
of  the  process  under  consideration,  are  clearly  not  essential  in 
any  of  its  stages." 

When  the  destructive  process  has  removed  the  whole  depth  of 
the  cartilage  to  the  bone,  and  when  the  laminal  layer  has  been 
removed,  the  breach  is  repaired  by  an  exudation  from  the 
vessels  of  the  bone,  which,  becoming  converted  into  bony 
matter,  occupies  the  affected  part. 


MORBID  CONDITION  OF  CARTILAGE.  223 

When  none  of  these  results  have  taken  place,  the  process 
of  destruction  is  arrested  and  limited  by  a  deposition  into 
the  bone  of  a  peculiarly  hard,  calcareous  material — the 
porcellaneous  deposit — which  fills  up  the  cavity,  and  blocks 
the  cancelli  and  canals  of  the  bone,  and  by  its  smooth  and 
polished  surface  makes  up  to  some  extent  for  the  want  of  the 
cartilage. 

In  old  horses  the  cartilage  of  incrustation  is  exceedingly  thin, 
and  in  some  cases  it  wdll  be  found  converted  by  ossification 
into  the  above-mentioned  ivory  or  porcellaneous  deposit.  This 
deposit  is  exceedingly  dense,  and  derives  its  hardness  from  the 
Haversian  canals  being  filled  up  by  additional  laminae. 

The  depressions  or  cavities  termed  sulci,  which  are  found  in 
many  close-fitting  joints,  as  the  elbow  and  true  hock  joints, 
must  not  be  mistaken  for  a  diseased  condition.  They  are  merely 
cavities  for  storing  synovia. 


TRAUMATIC  INFLAMMATION  OF  JOINTS. 

An  open  joint,  when  occasioned  by  puncture  or  incision,  is 
not  at  first  (if  unassociated  with  fracture)  attended  by  severe 
local  or  constitutional  disturbance ;  but  at  the  end  of  a  period 
varying  from  two  to  ten  days  pain  comes  on,  and  spreads  over 
the  joint,  w^hich  soon  presents  a  considerable  amount  of  swelling 
and  tension.  The  swelling  is  at  first  tense,  but  elastic ;  how- 
ever, it  soon  becomes  hard  and  unyielding,  and  accompanied 
by  great  constitutional  disturbance,  the  pulse  rising  in  frequency, 
becoming  hard  and  wiry  in  its  character,  and  the  animal  evincing 
acute  and  agonising  pain  by  partial  tremors  and  sweats  upon 
his  body.  In  fact,  all  the  constitutional  symptoms  indicate  a 
state  of  great  irritability.  The  lameness  is  excessive.  The 
animal  is  scarcely  able  to  put  its  foot  to  the  ground,  whilst  at 
the  same  time  the  pain  causes  it  to  keep  it  in  an  almost  con- 
tinual state  of  motion.  An  injury  not  at  first  penetrating  the 
joint  may  do  so  in  the  course  of  three  or  four  days,  by  sloughing 
of  the  tissues  around  it,  these  having  been  destroyed  but  not 
removed  by  the  violence  of  the  injury. 

The  discharge  of  synovia  may  be  very  trifling  for  some  days 
after  the  accident ;  but  it  gradually  increases  as  the  inflamma- 
tion advances,  is  thin  in  its  consistency,  and  mixed  with  flakes 


224  DISEASES  OF  THE  JOINTS. 

of  lymph ;  coagulates  upon  the  lips  of  the  wound,  and  oozing 
through  this  there  will  be  a  thin  watery  discharge.  There  is 
exudation  of  a  large  quantity  of  lymph  into  the  tissues  surround- 
ing the  joint,  which  becomes  partly  organized,  forming  a  hard, 
firm  swellinfT.  The  secretion  from  the  wound  is  now  unhealthy, 
purulent,  or  tinged  with  blood,  whilst  abscesses  begin  to  form 
around  the  articulation. 

The  fever  and  debility  increase  from  day  to  day  if  the  local 
symptoms  be  not  arrested ;  and  finally  the  animal  dies  from  the 
irritation. 

Condition  of  the  Part. — From  the  admission  of  air  into  the 
synovial  cavity,  inflammation  of  the  synovial  membrane  is 
excited ;  this  extends  into  the  extremities  of  the  bones  con- 
stituting the  articulation;  their  cancelli  become  turgid,  the 
Haversian  canals  enlarged ;  the  tissues  contained  within  them 
form  a  disorganized  mass,  infiltrated  with  ichor ;  absorption  of 
the  termination  of  the  vascular  part  of  the  bone  immediately 
contiguous  to  the  non- vascular  laminal  layer  ensues,  by  which 
it  is  detached  (along  with  the  cartilage  covering  it)  from  the 
extremity  of  the  bone,  and  may  be  found  floating  in  thin 
masses  in  the  synovia  within  the  joint.  This  process  goes  on 
simultaneously  at  the  extremities  of  both  the  bones  of  the 
articulation,  thus  exposing  their  vascular  interiors,  from  which 
loops  or  spongy  granulations  spring  up  luxuriantly.  These 
unite  with  each  other,  and  form  vascular  communications  from 
the  cancellated  structure  of  one  bone  to  that  of  the  other,  this 
being  the  first  step  in  the  process  of  internal  anchylosis.  From 
the  blood-vessels  of  these  new  formations  an  exudate  is  formed, 
which  is  finally  converted  into  bony  matter. 

These  granulations  easily  bleed,  and  when  blood  is  seen  in 
the  synovial  discharge,  the  veterinarian  will  understand  that  the 
laminal  extremities  of  the  bones  have  been  removed,  that  their 
vascular  interior  is  exposed,  and  that,  if  the  joint  affected  be  one 
of  extensive  motion,  it  will  be  useless  to  keep  the  animal  longer 
in  its  misery. 

Treatment. — The  treatment  of  open  joint,  to  be  successful, 
must  have  two  objects  in  view : — 1st.  To  promote  the  healing 
of  the  wound  by  the  first  intention,  or  by  the  adhesive  pro- 
cess. 2d.  To  prevent  inflammation.  For  these  purposes,  both 
local  and  general  measures  are  required,  the   local  being  the 


TRAUMATIC  INFLAMMATION  OF  JOINTS.  225 

more  important.  It  includes  the  apposition  of  the  lips  of  the 
wound  by  pinning,  or  by  suture,  which  must  be  either  metallic 
or  catgut.  If  there  are  any  foreign  bodies,  such  as  dirt,  gravel, 
or  portions  of  disintegrated  tissue  in  the  wound,  they  must  be 
carefully  removed  before  its  lips  are  brought  together.  To 
support  the  pin  or  suture,  and  to  prevent  the  admission  of  air 
and  germs  into  the  wound,  the  styptic  colloid,  shellac,  or 
collodion,  must  be  applied,  by  being  painted  on  in  successive 
layers  with  a  camel's-hair  pencil.  The  next  thing  to  be  done 
is  to  place  the  animal  in  slings  as  soon  as  possible.  I  consider 
this  essential  to  the  successful  treatment  of  open  joint,  as  it 
places  the  patient  in  the  most  favourable  position  for  repose, 
and  by  preventing  him  from  making  even  the  attempt  to  lie 
down,  does  away  with  the  danger  of  reopening  the  wound. 
All  other  local  applications,  by  interfering  with  the  healing 
process  in  the  wound,  are  at  this  stage  calculated  to  do 
harm. 

Wounds  upon  or  near  articulations  should  never  be  meddled 
with,  by  any  probing,  for  the  purpose  of  discovering  if  there 
be  fracture  of  the  bones.  If  fracture  exist,  the  lameness  wiU  be 
excessive  from  the  first.  A  meddlesome  interference  with  the 
probe  has  often  caused  open  joint,  when  the  original  injury  had 
not  penetrated  the  synovial  membrane. 

The  constitutional  treatment  must  be  that  calculated  to  lessen 
pain  and  irritation  ;  a  small  purgative,  combined  with  opium,  to 
be  followed  at  intervals  of  four  to  six  hours  by  doses  of  opium 
or  of  aconite ;  and  enemas  of  warm  water,  two  or  three  times 
a  day,  will  be  beneficial,  unloading  the  rectum,  and  enabling  the 
animal  to  pass  faeces  without  straining. 

If  the  wound  heal  by  these  measures,  and  the  inflammation 
of  the  joint  continue,  as  in  all  probability  it  will,  cold  must  be 
applied ;  and  the  best  method  of  doing  this  is  by  irrigation — 
that  is,  by  allowing  a  continual  stream  of  cold  water  to  trickle 
over  the  surface  of  the  joint.  This  is  easily  done  by  attaching 
a  gutta-percha  pipe  to  a  tap,  fastening  the  pipe  to  a  convenient 
part  of  the  slings,  and  carrying  its  free  extremity  on  to  the 
lame  limb,  and  fixing  it  above  the  inflamed  joint  by  means  of 
a  bandage.  If  no  tap  is  convenient,  a  tub  can  be  fixed  in  the 
loft  above  the  horse,  or  in  any  part  of  the  stable  above  the 
level  of  the  inflamed  joint,  and  the  pipe  inserted  into  an  aperture 

Q 


226  DISEASES  OF  THE  JOINTS. 

at  the  lower  part  of  the  tub,  which  is  to  be  well  supplied  with 
water.     A  very  small  stream  of  water  will  be  sufficient. 

If  this  plan  of  treatment  does  not  seem  to  succeed,  a  blister 
must  be  used. 

Practitioners  of  surgery  recommend  ice  in  gutta-percha  bags 
instead  of  water  :  these  are  scarcely  applicable  to  our  patients. 

Such,  then,  is  the  treatment  when  the  lips  of  the  wound  admit 
of  being  brought  into  apposition,  and  when  the  practitioner  has 
been  called  in  before  the  advent  of  suppuration.  If  it  be  a  lace- 
rated wound,  its  lips  must  be  brought  together  as  well  as  possible, 
and  retained  in  that  position  by  the  application  of  the  styptic 
colloid. 

If  these  means  are  ineffective,  if  the  injury  has  been  inflicted  for 
a  longer  period  than  a  few  hours,  when  inflammation  is  already 
established,  and  pus  has  commenced  to  be  formed,  to  plug 
up  the  wound  at  this  stage  would  only  cause  the  fluid  accumu- 
lated within  the  capsule  of  the  joint  to  burst  out  at  some  other 
spot.  The  application  of  the  actual  cautery,  of  hot  lime,  and 
of  the  various  caustics  and  astringents,  with  the  view  of  coagu- 
lating the  synovia,  as  recommended  by  many  teachers,  writers, 
and  practitioners,  cannot  be  too  highly  condemned ;  and  it  must 
always  be  remembered  by  the  practitioner  that  every  wound 
which  has  commenced  to  suppurate  must  heal  by  granulations ; 
and  that  the  more  perfect  formation  of  these  goes  on  in  the 
deeper-seated  parts  of  the  wound — that  is  to  say,  that  the  heal- 
ing must  be  from  within  outwards :  the  plugging  of  the  outer 
orifice,  while  pus  is  being  formed,  causes  it  to  accumulate  in  the 
joint  and  surrounding  structures,  adds  to  the  suffering  of  the 
animal,  and,  in  too  many  cases,  causes  its  death. 

An  extended  experience  warrants  me  in  recommending  the 
application  of  a  blister  to  the  whole  surface  of  the  joint,  as 
the  most  successful  treatment  that  can  be  adopted  if  the  wound 
has  failed  to  heal  by  the  primary  or  adhesive  process.  The 
blister  acts  by  removing  pain,  limiting  motion,  exciting  the 
formation  of  healthy  granulations,  and  (as  a  result  of  the  swell- 
ing it  produces)  causing  the  approximation  of  the  surfaces  of  the 
wound. 

The  coagulum  of  synovia  which  accumulates  upon  the  wound 
should  never  be  removed,  as  it  prevents  the  admission  of  air  and 
of  organic  germs  into  the  joint,  and  thus  limits  the  formation  of  pus. 


TRAUMATIC  INFLAMMATION  OF  JOINTS.  227 

Many  cases  when  so  treated  make  good  recoveries ;  but  if 
ulceration  of  the  cartilage  and  removal  of  the  laminal  ends  of 
the  bones  occur  (and  this  change  will  be  indicated  by  haemorr- 
hage, or  by  increased  pain  and  twitching  movements  of  the 
limb),  and  if  the  articulation  be  one  of  extensive  motion,  the 
attendant  will  understand  that  the  repair  can  only  be  by  anchy- 
losis, and  that  anchylosis  in  such  a  joint  will  render  the  animal 
unfit  for  further  use ;  but  if  the  joint  be  one  of  limited  motion, 
the  animal  may  become  fit  for  slow  work,  even  after  the  joint 
has  been  destroyed.  The  animal's  shoes  should  be  removed, 
provided  this  be  done  carefully,  and  before  great  lameness  has 
manifested  itself.  If  one  of  the  lower  articulations,  particularly 
of  the  fore  extremities,  be  the  seat  of  the  lesion,  the  animal  can 
be  made  to  stand  in  a  tub  of  cold  water,  and  the  trouble  of  affix- 
ing the  pipe  for  the  purpose  of  irrigation  be  avoided. 

All  cases  of  open  joint  require  a  long  period  of  rest  after 
the  wound  has  healed ;  and  it  is  generally  necessary  to  blister 
repeatedly,  or  even  to  fire,  before  the  remains  of  the  inflamma- 
tion excited  in  the  bones  and  synovial  membrane  are  finally 
removed. 

Several  abscesses,  some  mere  points  of  pus,  others  of  a  greater 
size,  form  in  the  exudate  which  has  been  formed  outside  of  the 
cavity  of  the  articulation  during  the  progress  of  the  disease.  It 
may  be  considered  necessary  to  open  them  surgically,  if  they 
cause  increased  pain.  It  may  be  well  to  do  so ;  but  if  they  are 
mere  accumulations  without  pain,  the  cautious  surgeon  will  not 
interfere,  rather  allowing  them  to  burst  spontaneously. 

The  horse  should  be  kept  in  the  slings  until  he  is  able  to  bear 
a  moderate  amount  of  weight  upon  the  affected  limb. 

During  the  early  period  of  the  disease,  the  food  must  be  spare, 
light,  and  cooling;  but  when  the  fever  has  abated,  it  must  be 
of  the  most  nourishing  kind,  in  order  to  compensate  for  the 
great  waste  of  tissue  and  emaciation  which  are  so  characteristic 
of  open  joint. 

DROPSY  OF  THE  JOINTS,  OR  HYDROPS  ARTICULORUM, 

Is  a  morbid  condition,  with  or  without  inflammation,  as  in  bog- 
spavin,  and  its  analogues  termed  wind-galls.  In  this  affection 
the  synovia  is  more  abundant  and  serous  than  is  natural,  and 


228  DISEASES  OF  THE  JOINTS. 

distends  whole  joints  or  bursae.  There  is  seldom  much  pain 
or  lameness,  because  the  ligamentous  and  other  textures  have 
been  yielding  gradually,  and  are  but  passively  distended  by  the 
fluid.  The  quantity  of  the  secretion  is  liable  to  variations,  dis- 
appearing more  or  less  upon  exercise,  and  accumulating  after  a 
short  rest.  During  long  periods  of  rest,  however,  the  accumula- 
tions may  disappear,  and  appear  again  when  the  animal  is  put 
to  work. 

Young  growing  cart-horses  are  very  subject  to  the  formation  of 
these  fluid  enlargements,  more  especially  about  the  hocks.  When 
they  are  full  grown,  however,  their  joints  may  become  quite  fine. 

The  treatment  most  appropriate  is  the  application  of  blisters 
and  pressure ;  but  this  will  be  again  referred  to  under  the  head 
of  Lameness. 


ANCHYLOSIS,  OR  THE  STIFFENING  OF  THE  JOINTS. 

There  are  several  forms  of  anchylosis : — 1st.  Osseous,  or  true ; 
2d.  Fibrous ;  3d.  Ligamentous ;  Ath.  Spurious. 

1st.  The  true  anchylosis  may  be  general  and  complete  at  every 
part  of  the  joint,  as  in  some  bone-spavins  and  true  ring-bones, 
where  all  trace  of  the  articulation  has  been  lost,  and  the  opposing 
bones  so  firmly  united  as  to  appear  as  one  bone.  Before 
this  can  happen,  the  articular  cartilages  and  laminal  layers  of 
the  opposing  bones  must  be  removed  by  an  ulcerative  absorp- 
tion, and  an  exudate  thrown  out  from  their  cancellated  structure ; 
which,  becoming  organized  into  bony  matter,  cements  the  bones 
together.  This  is  the  natural  termination  and  cure  of  such 
causes  of  lameness,  and  it  is  accompanied  by  a  deposition  of 
bone  upon  the  outside  of  the  affected  joint,  which  aids  in  the 
completion  of  the  anchylosis. 

2d.  The  fibrous. — The  opposing  surface  of  the  bones  may  be 
united  by  fibrous  tissue.  As  a  rule,  however,  this  is  only  found 
during  the  earlier  stages  of  true  anchylosis. 

Sd.  The  ligaments  become  rigid  to  such  an  extent  as  to  make 
a  joint  more  or  less  stiff  and  immoveable,  wliilst  the  articular 
surfaces  of  the  bones  remain  healthy.  Stiff  joints  of  old  horses 
are  examples  of  this. 

4:th.  The  spurious  is  that  which  depends  on  deposition  in  tex- 
tures external  to  the  joint,  uniting  the  various  structures  to  each 


ANCHYLOSIS.  229 

other.  This  form  is  always  present  to  some  extent  after  acute 
inflammation  of  a  joint ;  and  appears  around  the  lower  joints  of 
a  limb  which  is  mal-formed  by  contraction  of  the  flexor  tendon, 
or  rupture  of  the  suspensory  ligament,  as  shown  in  Photo-litho- 
graph, Plate  III.,  Fig.  6.  This  form  can  be  removed  by  forcible 
extension  of  the  articulation,  after  division  of  the  contracted 
tendon.  It  is  also  present  to  some  extent  after  open  joint  suc- 
cessfully treated,  and  disappears  gradually  by  absorption  when 
the  joint  is  brought  into  use.  Its  removal  may  be  accelerated 
by  repeated  applications  of  iodine  to  the  skin. 


ANCHYLOSIS,  OE  THE  STrFFENING  OF  THE  JOINTS. 


EXPLANATION  OF  PHOTO-LITHOGRAPH,  PLATE  IIL 

1.  Anchylosis  of  Shoulder- Joint. 

2.  Incipient   Anchylosis    of   Elbow- Joint,  sliomng  removal  of 
cartilage  and  laminal  layer  of  the  bone,  on  extremity  of  humerus. 

3.  4.  and  5.  show  Anchylosis  of  the  Carpal,  and  First  and 
Second  Phalangeal  Articulations. 

6.  Anchylosis  and  Destruction  of  all  the  Phalangeal  Articula- 
tions in  an  old-standing  case  of  "  Break-down." 


«r 


-FLATB  JH 


^^^^|P^-4 


■^i>^ 


Jtumess  <f  CcmpartyMdxnT 


CHAPTEE  XIL 

LAMENESS. 

DIAGNOSIS — DEFINITION  — SIGNS — CAUSES  —  CONGENITAL     MUSCULAR 

ATONY EMBOLI METHODS  OF  EXAMINATION SPRAINS STRAINS 

OF  PSO^  MUSCLES — CHOREA — STRINGHALT SHIVERING. 

Having  entered  into  the  pathology  of  the  Diseases  of  Bones  and 
Articulations,  I  shall  now  consider  the  question  which  may  be 
looked  upon  as  being  the  one  to  which  the  greatest  importance 
may  be  attaclied,  namely,  that  of  Lameness. 

Diagnosis  of  Lameness. — The  readiness  with  which  some  men 
are  able  to  detect  lameness  seems  to  be  an  instinctive  gift.  Of 
such  was  Professor  Dick,  who  could,  at  a  glance,  even  when  a 
horse  had  been  moved  but  a  few  yards,  tell  the  seat  and  the 
cause  from  which  he  was  lame.  But  whilst  this  is  so  easy  a 
matter  to  some,  to  others  it  is  a  task  of  great  difficulty,  requiring 
long-continued  practical  study  and  observation.  There  are,  how- 
ever, cases  where  the  most  experienced  are  at  a  loss,  and  where 
even  the  most  skilful  differ  in  opinion.  To  the  young  man 
entering  upon  the  duties  of  his  profession,  this  matter  is  aj^t 
to  cause  many  anxious  thoughts  and  uneasy  moments,  as  a 
mistake  at  this  period  may  interfere  very  materially  with  his 
success  in  life.  To  such  I  would  say,  Never  express  a  de- 
cided opinion  until  you  are  thoroughly  satisfied  as  to  its 
correctness. 

The  first  point  to  be  determined  is  the  limb  in  which  the 
patient  is  lame.  This  may  seem  an  easy  matter,  but  in  reality 
it  is  attended  with  no  little  difficulty.  Thus,  a  mistake  may  be 
made  by  expressing  an  opinion  that  the  lameness  is  in  the 
hind  leg,  when  in  reality  it  is  in  the  fore,  and  vice  versa.     This 


282  LAMENESS. 

error  has  been  so  often  committed,  that  the  peculiarity  of  gait 
which  has  led  to  it  has  been  called  "  cross-lameness."  For 
example,  a  horse  lame  in  the  off  fore  leg  is  trotted  from  the 
observer ;  he  seems  as  if  he  were  lame  in  the  near  hind,  for  the 
quarter  seems  to  ascend  and  descend.  But  when  the  animal 
is  trotted  towards  the  observer,  it  will  be  seen  that  the  irregu- 
lar motion  of  the  hind  quarters  depends  upon  the  elevation 
and  dropping  of  the  head  and  body ;  and  that  the  lameness  in 
reality  is  in  the  fore,  and  not  the  hind  limb.  An  opinion  must 
not  be  given  before  the  horse  has  been  trotted  from  and  towards 
the  observer.  Of  course  there  are  many  cases  where  lameness 
is  so  apparent  that  such  an  examination  is  quite  uncalled  for ; 
at  the  samo  time,  there  are  many  other  cases  so  slight  in  degree 
as  to  require  the  most  rigid  scrutiny. 

The  next  difficulty  is  the  detection  of  lameness  when  it  is 
situated  in  both  fore  feet.  When  such  is  the  case,  an  animal 
may  seem  to  go  as  if  sound.  Advantage  has  been  taken  of  this 
by  low  horse-dealers,  who,  when  they  have  a  horse  lame  in  one 
fore  foot,  make  him  lame  in  the  other  also.  This  is  by  them 
technically  termed  "  Beaning,"  and  consists  in  placing  a  small 
piece  of  iron  tightly  under  the  shoe  of  the  sound  foot,  which 
produces  so  much  pain  as  to  cause  lameness.  A  more  refined 
method  has  latterly  come  into  vogue,  that  of  paring  the  toe  of 
the  sound  foot  nearly  to  the  quick,  and  so  adapting  the  shoe 
as  to  press  upon  the  weakened  spot. 

A  horse  lame  in  both  feet,  although  he  may  not  drop  in  his 
<7ait,  will  be  short  in  action;  will  go,  as  it  has  been  more 
forcibly  than  elegantly  expressed,  "like  a  cat  on  hot  bricks." 
Each  foot  is  carefully  put  to  the  ground,  and  quickly  lifted  up 
af^ain,  while  at  the  same  time  there  is  a  rolling  motion  of  the 
body.  In  other  cases  he  may  exhibit  the  lameness  in  one  foot 
as  he  goes  from,  and  in  the  other  as  he  approaches  the  observer. 
Such  cases  are  very  confusing,  and  require  all  the  veterinary 
surf^eon's  discriminative  powers.  Care  must  be  taken  not  to 
confound  peculiarity  of  action  with  lameness.  For  example,  a 
horse,  especially  a  young  one,  may  appear  lame  in  the  near 
fore  foot,  if  led  with  a  short  rein,  and  his  head  pulled  to  one 
side,  or  when  he  is  first  bitted.  This  is  called  "  bridle  lame- 
ness ;"  it  disappears  when  the  animal  is  run  in  a  slack  rein. 
Af^ain,   horses  which  are   habitually   exercised   in   a   ring,   or 


SIGNS  OF  LAMENESS.  233 

round  a  circle,  invariably  seem  lame  upon  the  fore  limb  nearest 
the  centre  of  the  ring.  When  the  lameness  is  in  both  hind 
limbs,  the  difficulty  of  diagnosis  is  not  so  great,  as  the  animal 
is  both  stiff  and  lame ;  but  mere  stiffness  must  be  distinguished 
from  lameness,  although  it  is  often  confounded  with  it.  No 
doubt  a  stiff  horse  is  an  unsoimd  horse ;  but  he  may  be  very 
useful  for  slow  work,  and  at  a  suitable  price.  Mere  stiffness 
may  indicate  age  or  fatigue,  and  often  passes  away  after  a  little 
exercise;  but  lameness  is  indicative  of  actual  pain  or  disease, 
and  although  it  may  pas3  off  with  exercise,  still  it  must  not  be 
confounded  with  stiffness. 

There  are  some  forms  of  lameness  which  are  apparent  in  the 
stable  only,  the  movements  caused  by  bringing  the  patients 
out  of  the  stable  being  sufficient  to  produce  the  total  disappear- 
ance of  the  lameness.  Such  being  the  case,  the  examiner 
should  see  the  horse  in  the  stable  as  well  as  out  of  it. 

The  manifestation  of  lameness  by  the  animal  is  sho^vn  in 
two  ways: — 1st.  During  repose;  2d.  During  movement.  In 
some  cases,  the  appearance,  or  expression,  is  much  more  pal- 
pable while  the  animal  is  standing  still,  as  in  many  foot  lame- 
nesses. For  example,  a  horse  will  continually  point,  or  even 
elevate,  the  foot  which  is  suffering  pain  ;  if  both  feet,  each  foot 
alternately  will  be  pointed  or  elevated.  But  if  he  is  made  to 
move,  the  extent  of  the  lameness  does  not  seem  equivalent 
to  the  amount  of  pain  so  expressed.  In  other  cases,  the  patient 
will  stand  perfectly  firm,  although  in  the  great  majority  of  cases 
the  pastern  of  the  lame  limb  is  more  upright  than  that  of  the 
sound  one,  as  if  he  feared  to  put  as  much  weight  upon  it ;  but 
when  made  to  move,  he  will  immediately  exhibit  the  lameness. 
Again,  many  cases  are  seen  in  practice  where  the  patients  come 
out  of  the  stable  sound,  but  when  they  have  performed  some 
work  or  exercise,  lameness  becomes  manifest.  Others,  again, 
leave  the  stable  very  lame,  and  become  freer  in  their  action 
when  they  have  been  warmed  with  exercise.  Such  cases  are 
apt  to  deceive;  therefore  the  veterinary  surgeon  should  take 
every  precaution  against  being  taken  unawares.  Some  horses 
exhibit  their  lameness  when  they  "  turn  round."  They  may  go 
weU.  enough  if  led  straight  to  or  from  the  observer ;  but  when 
sharply  turned  round,  they  at  once  manifest  their  unsoundness  ; 
and  when  an  examiner  as  to  soundness  finds  a  man  turn  his 


234  LAIVIENESS. 

liorse  "  carefully  round,"  he  should  watch  narrowly,  and  com- 
pel him  to  be  turned  quickly.  Slight  chorea  or  stringhalt 
is  seldom  detected  except  during  the  turn,  and  I  have  seen 
cases  where  it  was  manifested  when  the  animal  was  turned  one 
way  only. 

In  other  cases  lameness  may  exist  in  two  or  more  limbs, 
but  not  equally;  and  when  so  complicated,  the  animal  may 
endeavour  to  save  the  lame  limbs  by  throwing  his  weight  from 
tliem  in  a  manner  so  peculiar  that  it  requires  great  care  to 
distinguish  the  true  nature  of  the  case,  and  to  form  a  correct 
opinion. 

Again,  there  are  some  horses  which  walk  down  hill  in  so 
peculiar  a  manner,  that  they  may  be  supposed  to  be  lame. 
Tliis  kind  of  walk  has  been  termed  a  "  three-cornered  walk." 
The  animal  sways  from  side  to  side  most  awkwardly ;  his  hind 
quarters  being  turned  to  the  one  side  or  the  other,  going  forwards 
hroadside-on,  similar  to  an  animal  going  down  hill  with  a  heavy 
load  behind  him.  Young  horses,  when  being  broken-in,  should 
be  corrected  of  this  fault,  as  it  is  most  unsightly  ;  and  to  see  a 
rider  on  a  horse  of  this  kind  reminds  one  very  forcibly  of  Don 
Quixote  and  Eosinante. 

A  touch  of  the  whip  or  spur  will  cause  the  horse  to  improve 
his  paces,  and  at  once  show  that  it  is  not  lameness,  but  laziness, 
from  which  he  is  suffering. 

The  signs  of  lameness  manifested  during  repose  are  very 
important,  and  sometimes  diagnostic.  A  horse  suffering  acute 
pain  in  one  of  his  legs  will,  if  it  be  a  fore  limb,  point  the  foot : 
by  pointing  is  meant  the  extension  of  one  limb  in  advance 
of  its  fellow.  This  is  done  for  the  purpose  of  relieving  pain, 
and  is  performed  by  throwing  the  flexors  into  a  state  of  relaxa- 
tion, and  removing  any  tension  or  pressure  from  the  painful 
part.  This  pointing  does  not  apply  to  every  lameness  in  a  fore 
limb,  nor  particularly  to  any  cause  of  it,  for  in  some  rare  in- 
stances a  horse  may  be  lame  in  both  fore  feet  from  chronic 
navicular  disease,  yet  never  point. 

The  pointing  of  elbow  lameness  is  characteristic,  the  fore 
arm  being  extended,  the  knee  in  a  state  of  flexion,  and  the  foot 
perhaps  upon  a  level  with  or  posterior  to  its  fellow.  In  severe 
shoulder-lameness,  the  pointing,  if  it  can  be  called  such,  is 
backwards,  the  limb  relaxed,  the  knee  bent,  and  the  foot  pos- 


SIGNS  OF  LAMENESS.  235 

terior  to  its  fellow  ;  sometimes  the  toe  only  touching  the  ground ; 
the  whole  of  the  limb  semi-pendulous,  consequent  upon  the 
inability  of  the  muscles  to  elevate  and  bring  it  forward  without 
pain  ;  as  a  man  fails  to  lift  his  arm  when  his  shoulder  is  injured 
or  diseased. 

If  the  lameness  be  in  a  hind  limb,  the  patient  may  stand  with 
it  either  flexed,  "knuckling  over"  at  the  fetlock,  or  with  the 
foot  off  the  ground  altogether.  When  he  stands  with  his  lame 
(hind)  leg  in  advance  of  the  sound  one,  the  position  generally 
indicates  disease  in  or  below  the  hock. 

A  horse  with  acute  pain  in  the  fore  feet  will  stand  with  his 
hind  ones  advanced  beneath  the  body,  resting  first  one  fore  foot 
and  then  the  other,  and  every  time  he  moves  will  rear  up  his 
head,  and  stretch  out  his  neck  in  expression  of  the  pain  he 
suffers ;  but  should  the  pain  be  in  both  hind  feet,  he  will  stand 
with  his  fore  feet  beneath  his  chest  and  towards  the  central  line 
of  gravity ;  his  body  pushed  forwards,  and  head  hung  down,  in 
order  to  remove  the  weight  as  far  as  possible  from  the  seat  of 
pain.  He  will  first  ease  one  hind  foot,  and  then  the  other, 
breathing  heavily,  and  showing  other  signs  of  acute  pain.  Pain 
in  both  hind  feet  often  interferes  with  the  act  of  urination,  by 
preventing  that  stretching  of  the  body  which  is  so  characteristic 
of  that  act  in  the  horse.  In  such  cases  the  poor  patient  will 
endeavour  to  stretch  himself,  will  elevate  the  tail,  but  with  a 
groan  quickly  assume  his  former  posture,  and  suddenly  "  pick 
up "  the  feet  alternately.  From  this  fact  it  is  often  supposed 
that  a  horse  suffering  acute  pain  in  the  hind  feet  has  some  disease 
of  the  urinary  organs. 

The  practitioner  having  satisfied  himself  which  leg  an  animal 
is  lame  in,  he  must  now  endeavour  to  find  out  the  seat  of  its 
cause.  The  late  Professor  Dick  taught  us  to  cause  the  shoe 
to  be  removed,  and  the  foot  examined  in  every  case  of  lame- 
ness. This  is  a  good  rule  to  be  followed,  especially  by  young 
practitioners.  He  used  to  relate  a  case  (showing  the  importance 
of  this  rule)  where  the  os  suffraginis  was  fractured.  His  great 
skill  in  lameness  led  him  to  think,  upon  examination,  that  the 
fracture  was  not  the  only  cause  of  the  lameness;  he  had  the 
shoe  removed,  and  discovered  a  wound  from  a  nail  in  the  foot, 
containing  purulent  matter.  The  fact  of  the  horse  being  injured 
in  the  foot  explained  the  cause  of  the  fracture, — the  animal,  on 


236  LAMENESS. 

account  of  the  pain,  having  trod  unevenly,  prevented  the  equal 
distribution  of  his  weight,  and  caused  the  fracture.  The  Pro- 
fessor had  the  foot  attended  to,  as  well  as  the  fracture,  and  the 
patient  made  a  good  recovery.  Now,  had  he  been  satisfied,  as 
the  majority  of  men  would  have  been,  that  the  fracture  was  the 
only  cause,  the  purulent  matter  confined  in  the  foot  would  have 
forced  its  way  out  at  the  coronet,  a  high  degree  of  fever  would 
have  been  excited,  the  case  much  complicated,  and  the  Professor 
accused  of  mal-treatment. 

After  duly  examining  the  foot,  and  being  satisfied  that  the 
lameness  is  not  there,  the  practitioner  must  endeavour  to  find 
out  where  it  is ;  but  before  considering  the  various  lamenesses 
in  detail,  we  must  refer  to  .the  definition  of  the  word  and  the 
variety  of  its  causes. 

The  word  lame,  according  to  Percivall,  is  from  the  Anglo- 
Saxon  lam,  weak;  the  terms  lame  and  weak  are  synonymous 
in  some  parts  of  England ;  thus  it  is  a  common  expression 
to  hear,  "  that  is  a  lame  story,"  for  a  weak  story ;  or  a  "  lame 
sermon,"  for  a  poor,  weak  sermon ;  and  more  commonly,  a  "  lame 
excuse." 

The  same  writer  defines  it  to  be — "  The  manifestation  in  the 
act  of  progression,  by  one  or  more  of  the  limbs,  of  pain,  weakness, 
inability,  or  impediment." 

This  definition  is  very  near  the  mark,  but  I  think  it  would 
read  better  as  follows : — A  manifestation  by  one  or  more  of  the 
limbs,  of  pain,  weakness,  inability,  or  impediment;  the  act  of 
progression  not  being  necessary  to  the  manifestation  of  such. 
Percivall,  however,  must  always  be  looked  upon  as  a  great 
authority,  as  he  seems  to  have  been  a  practical  man  in  most 
matters,  as  well  as  an  elegant  writer. 

Lameness  is  not  of  itself  a  disease,  but  a  sign  of  it.  It  is  the 
expression  of  pain  or  inability,  the  result  of  disease,  accident,  or 
malformation  in  the  limb  or  limbs  by  which  it  is  manifested. 
It  may,  however,  arise  from  disease  apart  from  the  limbs,  as  from 
injury  to  or  diseases  of  the  spinal  cord  or  nerves,  from  cerebral 
disease,  and  occasionally  disease  of  the  liver.  It  may  exist  for 
a  short  time  independent  of  disease — a  mere  expression  of  pain 
without  disease,  as  from  a  stone  in  the  foot,  or  a  badly -fitting 
shoe ;  but  if  these  causes  of  pain  exist  for  any  length  of  time, 
indammation  is  sure  to  follow.     Disease  much  oftener  exists 


CAUSES  OF  LAMENESS.  237 

in  a  limb  without  lameness  than  lameness  without  disease. 
Thus,  a  horse  may  have  a  wound,  ulcer,  bony  deposit,  or  a 
tumour,  without  evincing  lameness.  From  these  particulars  we 
may  argue  that  lameness  is  never  present  without  pain,  although 
Percivall  asserts  that  inability,  in  the  absence  of  pain,  will  be 
found  as  a  cause  of  lameness,  and  he  says — "  Dislocation  of  the 
patella  occasions  no  pain,  and  yet  the  horse  is  too  lame  even  to 
move.  The  partial  or  complete  anchylosis  of  a  joint  may  cease 
to  be  attended  with  pain,  and  yet  there  may  be  permanent  and 
irremoveable  lameness."  I  think  we  may  safely  take  exception 
to  these  conclusions,  as  they  are  not  borne  out  by  every-day 
experience. 

Complete  anchylosis  may  exist  without  pain,  and  yet  the 
patient  is  lame  ;  but  it  will  be  found  that  such  anchylosis  exists 
in  some  joint  of  extensive  motion,  and  prevents  flexion  and  ex- 
tension in  the  whole  limb. 

Pain,  then,  may  be  generally  said  to  be  the  common  cause  of 
lameness.  The  patient  feels  the  pain  either  when  it  moves  the 
limb,  or  when  it  bears  weight  or  presses  upon  it.  During  motion 
the  patient  endeavours  to  avoid  throwing  pressure  upon  the  lame 
limb,  by  treading  lightly  or  stepping  short,  and  by  removing 
weight  as  far  from  the  seat  of  pain  as  it  possibly  can,  not  only 
by  using  the  lame  limb  in  a  manner  best  calculated  for  this 
purpose — as  by  treading  on  the  heels  when  the  pain  is  in  the 
anterior  part  of  a  limb  or  foot,  and  upon  the  toes  when  in  the 
posterior  part — but  also  by  throwing  the  w^eight  from  the  lame 
limb  as  much  as  it  possibly  can. 

Weakness  of  the  limbs  may  cause  lameness  and  inability  to 
perform  the  function  of  progression  properly.  A  characteristic 
example  of  this  has  been  described  by  Mr.  George  Armatage, 
under  the  title  of  "  Congenital  Muscular  Atony,"  or  a  want  of 
development  of  muscular  fibre  in  the  extensor  muscles  of  the 
fore  arm  of  foals.  In  this  form  of  lameness  the  animal  stands 
almost  upon  the  front  part  of  the  fetlock-joints ;  the  flexor 
muscles  healthy,  fully  developed,  and  having  no  antagonistic 
power  opposed  to  them,  in  consequence  of  the  arrested  develop- 
ment of  the  extensors,  draw  up  the  limbs  posteriorly ;  the  heel 
of  the  foot  and  the  fetlock  pad  being  in  close  contact,  the  little 
animal  beino^  at  the  same  time  almost  unable  to  move.  I  have 
found  this  kind  of  lameness  occurring  at  any  time  during  the 


238  LAMENESS. 

first  year  of  the  animal's  life,  and  it  may  not  always  be  viewed 
as  "  congenital."  Grazing  on  very  bare  pastures  is  apt  to  cause 
it,  more  especially  if  the  foal  be  short  in  the  neck,  or  when  so 
formed  that  he  has  to  bend  over  on  his  fore  limbs  considerably 
before  he  is  able  to  obtain  his  bite  of  grass.  Continuance  in  this 
position  for  a  long  time  each  day  causes  a  weakening  and  arrest- 
ment of  development  of  the  extensor  muscles,  whilst  at  the  same 
time  the  flexors  called  into  action  are  excited  to  increased 
development.  We  have  thus,  concomitantly,  atrophy  of  the 
extensors  and  hj^pertrophy  of  the  flexors. 

Mr.  Armatage  recommends  the  continued  application  of 
mild  blisters  to  the  anterior  region  of  the  arm,  to  excite  the 
exudation  of  plastic  material  and  the  development  of  the 
exudate  into  muscular  fibre,  and,  by  bringing  more  blood  to 
the  part,  to  increase  its  tone  and  power,  and  elevate  its  func- 
tional activity. 

A  horse  may  be  lame  from  excess  of  tonicity  in  the  muscles 
of  a  limb,  accompanied  by  much  pain,  as  in  cramp,  which  renders 
him  for  the  time  being  dead  lame. 

In  other  cases  lameness  may  be  due  to  disease  in  the  blood- 
vessels of  the  limb  or  their  parent  trunks.  For  example,  most 
extreme  lameness  is  manifested  in  limbs  when  their  "arteries 
of  supply"  become  plugged  by  emboli  (fibrinous  plugs).  A 
case  of  this  kind  occurred  in  my  own  practice,  where  a  horse 
became  dreadfully  lame,  and  exhibited  symptoms  of  great  agony 
whenever  put  to  work,  while  in  the  stable  no  signs  of  pain  were 
present ;  but  when  he  had  worked  in  the  carriage  for  about  500 
yards,  he  would  show  signs  of  weakness  in  one  hind  limb, 
commence  to  sweat,  and  finally  become  immoveable  with  pain. 
After  a  short  period  of  repose,  these  symptoms  would  dis- 
appear, but  appear  again  if  any  attempt  was  made  to  work 
him. 

In  addition  to  pain  and  lameness,  the  limb  was  deathly  cold 
to  the  touch,  and  upon  a  post  mortem  examination  being  made, 
the  external  iliac  artery  of  that  side  was  found  nearly  oblite- 
rated by  a  deposition  of  fibrine. 

In  the  detection  of  the  lame  limb,  the  following  rules  may  be 
laid  down  for  the  guidance  of  the  young  practitioner : — "When 
the  lame  limb  comes  to  the  ground  during  progression  the 
animal  suddenly  elevates  that  side  of  his  body  and  drops  the 


METHODS  OF  EXAMINATION.  239 

other  side.  If  the  lameness  be  in  a  fore  limb  the  head  as  well 
as  the  fore  part  of  the  trunk  is  raised  from  the  lame  and  drojyj^ed 
upon  the  sound  limb.  This  is  called  "  nodding."  If  the  lame- 
ness be  in  a  hind  limb,  the  quarter  of  the  same  side  will  be  ele- 
vated and  that  of  the  sound  side  thrown  forwards  and  downwards 
by  a  jerking  motion ;  the  head  being  moderately  steady  if  the 
pain  be  not  great,  and  jerked  if  there  be  acute  agony.  It  is 
only  by  carefully  noting  these  facts  that  we  are  able  to  detect 
the  limb  in  which  an  animal  may  be  lame. 

The  signs  indicative  of  the  seat  of  lameness  are  of  two 
kinds : — (1.)  Those  manifested  by  action ;  and  (2.)  Those  dis- 
coverable by  examination,  while  the  animal  is  in  a  state  of 
rest.  In  some  instances  the  latter  are  alone  sufficient  to  indi- 
cate the  seat  and  nature  of  the  disease,  but  the  lameness  must 
be  of  a  severe  character,  manifested  by  "pointing,"  standing 
with  the  lame  limb  flexed,  or  even  completely  elevated  from 
the  ground;  or,  as  in  laminitis,  with  the  unaffected  feet  and 
limbs  placed  as  much  under  the  body  as  possible. 

In  the  majority  of  cases,  however,  it  is  necessary  to  cause 
the  patient  to  perform  some  movement ;  and  it  is  agreed  by  all 
practical  men  that  the  slow  trot  is  the  best  pace.  A  horse  may 
walk  lame,  but  if  such  be  the  case,  he  must  be  very  lame. 
There  are  cases,  however,  as  in  "  slight  splint  lameness,"  where 
it  is  necessary  to  urge  the  animal  to  a  sharp  trot  before  any 
deviation  from  the  normal  gait  can  be  distinguished. 

The  following  rules  may  be  useful  for  the  guidance  of  young 
practitioners  : — The  horse  should  be  led  out  of  the  stable  in  a 
snaffle  bridle,  with  the  rein  over  the  head.  Let  the  man  who 
leads  him  be  ordered  to  hold  the  rein  at  about  eighteen  inches 
from  the  mouth,  and  let  there  be  no  holding  up  of  the  animal's 
head  by  a  tight  curb  or  rein,  to  prevent  "  nodding ; "  but,  at 
the  same  time,  the  rein  must  not  be  too  long,  for  if  this  be  the 
case,  a  spirited  animal  may  turn  round  so  far  as  to  kick  the 
man  with  his  hind  foot.  The  horse  should  be  trotted  im- 
mediately after  he  is  taken  out ;  and  for  this  reason,  that  any 
very  slight  lameness  may  disappear  if  he  be  walked  any  dis- 
tance. Many  low  dealers  will  knock  a  horse  about  in  the 
stall  to  remove  such  lameness.  This  should  be  looked  to  in 
every  suspicious  case.  If  the  horse  be  frisky,  he  must  be  cooled 
down  and  very  carefully  led,  in  order  that  the  examiner  may 


240  LAMENESS. 

have  a  fair  chance.  It  has  been  already  stated  that  it  is 
necessary  to  make  the  horse  run  both  from  and  to  the 
observer,  and  it  may  be  necessary  to  do  this  repeatedly ;  but  if 
an  examiner  cannot  determine  the  existence  in  two  or  three 
minutes,  it  is  better  to  put  the  horse  up  again,  as  the  exercise 
has  a  tendency  to  decrease,  or  even  to  remove  the  lameness.  In 
some  very  slight  cases,  it  may  be  necessary  to  place  a  rider  on 
the  horse,  as  the  weight  upon  the  back  will  cause  the  mani- 
festation of  the  lameness.  As  a  rule,  however,  it  is  better  not 
to  do  this,  especially  if  the  animal  be  a  spirited  one. 

There  are  some  lamenesses  which  are  only  manifested  after 
sharp  work,  and  in  such  cases  it  is  necessary  to  give  the  horse 
half-an-hour's  trot  or  gallop,  tying  him  afterwards  in  a  stall 
until  he  becomes  cool.  When  taken  out  of  the  stable  and 
trotted  after  such  a  test,  lameness,  if  in  existence,  will  most 
assui-edly  be  detectable.  Some  veterinary  surgeons  do  this 
with  every  horse  they  examine ;  but  it  is  quite  needless  in 
ordinary  cases,  and  it  is  only  when  some  suspicion  exists  that 
such  a  test  is  necessary,  such  as  badly-formed  hocks,  splints 
near  the  knee,  or  some  alteration  of  structure  in  any  part  of 
the  limb,  or  in  cases  w^here  there  is  "  pointing  "  while  at  rest, 
or  where  the  disease  is  very  slight. 

The  gait  only  is  sometimes  sufficient  to  determine  the  seat 
of  lameness,  and  in  some  cases  it  is  the  only  guide  ;  but  it  is 
a  good  rule,  and  one  that  should  never  be  neglected,  to  examine 
the  lame  limb  while  the  animal  is  in  a  state  of  rest. 

By  the  latter  method  we  discover  lameness  by  positive  and 
negative  signs.  For  example,  if  there  be  heat,  pain,  or  swelling 
in  any  part  of  the  limb,  discoverable  by  manipulation,  the 
evidence  is  'positive  that  the  cause  is  in  such  a  part;  but  if, 
on  the  other  hand,  there  be  neither  pain,  heat,  nor  swelling 
in  the  Hmb,  nothing  in  the  superficial  parts  of  the  foot  to 
account  for  it,  we  must  conclude  that  it  is  deep-seated  in  the 
foot,  or  in  a  part  thickly  clothed  by  healthy  tissues,  and  we 
must  arrive  at  a  conclusion  by  negative  evidence,  assisted  by 
peculiarities  of  gait. 

Lameness  may  be  caused  by  a  strain  of  a  ligament,  muscular 
tissue,  tendon,  by  fractures,  diseased  bones,  cartilage,  or  fibro- 
cartilage,  morbid  conditions  of  the  skin ;  neuromatous  and  other 
tumours;  plugging  of  arteries;  accidents,  as  "pricks"  in  shoe* 


CAUSES  OF  LAMENESS.  241 

ing,  "treads,"  wounds,  ulcers,  rheumatism,  and  reflex  nervous 
action,  as  in  diseased  liver. 


A  SPRAIN,  OR  STRAIN, 

Is  violence  inflicted  upon  any  soft  structure,  with  extension,  and 
often  rupture  of  its  fibres.  Professor  Dick  was  of  opinion  that 
there  was  always  rupture  of  the  fibres  in  a  sprained  tendon  or 
ligament.  But  I  think  that  the  condition  which  we  term  strain 
may  arise  from  repeated  extension  or  slight  stretching,  without 
the  fibres  being  at  first  ruptured  at  all;  and  that  an  altered 
nutrition  is  so  produced,  which  leads  on  to  inflammation  of  the 
part,  and  finally  to  the  softening  of  some  portion  of  the  fibres, 
by  which  they  lose  their  toughness,  and  become  broken  across. 
A  very  slight  strain  may  be  a  mere  bruise,  with  ecchymosis; 
whereas  violent  and  great  extension  may  rupture  the  whole 
structure  of  a  part. 

Extension  is  not  always  the  cause  of  a  strain,  as  a  muscle  may 
be  injured  by  the  opposite  condition,  namely,  violent  contrac- 
tions ;  its  fibres  and  their  thecse  broken  across  their  long  axes  ;  or 
its  tendinous  fibres  torn  from  their  attachments  at  either  or  both 
of  its  extremities. 

Strains  may  be  confined  to  the  thecse  or  sheaths  only,  but 
these  are  of  but  little  importance  compared  with  injury  to  the 
ligaments  or  tendons  themselves.  It  has  been  already  stated 
that  synovitis  may  arise  from  strain  of  a  ligament,  by  the  inflam- 
mation extending  to  the  small  synovial  surface  which  is  found 
on  most  "  binding  ligaments." 

Muscular  strains  are  found  in  various  parts  of  the  trunk  and 
limbs.  Thus,  a  horse  may  be  strained  in  the  neck,  as  a  result 
of  a  fall  upon  the  head.  If  the  fall  be  very  severe,  the  strain 
may  be  complicated  with  severe  injury  to  the  spinal  cord,  or 
with  fracture  of  the  vertebrae,  causing  perhaps  the  sudden  death 
of  the  animal. 

The  muscles  of  the  dorsal  region  may  be  sprained  by  the  hind 
feet  slipping  backwards.  When  a  muscle  is  strained  the  injury  is 
succeeded  by  pain,  swelling,  heat,  and  loss  of  function.  An  in- 
flamed muscle  can  no  longer  contract ;  hence,  in  some  strains, 
the  symptoms  resemble  those  of  paralysis. 

This  swelling  of  an  inflamed  muscle  is  very  often  succeeded 


242  LAMENESS. 

by  loss  of  substance  (atrophy),  and  sometimes  by  fatty  degene- 
ration of  its  fibres,  whereby  they  lose  their  red  fleshy  appear- 
ance, and  assume  that  of  wliitish  threads  of  fat.  When  micro- 
scopically examined,  the  sarcous  elements — the  real  contractile 
tissue  within  the  sarcolemma — is  replaced  by  glistening  oil 
particles,  so  that  the  functional  power  is  completely  destroyed. 
If  the  whole  muscle  be  involved,  its  contractile  power  no  longer 
exists ;  and  this  loss  of  power  will  vary  according  to  the  extent 
of  the  muscular  structure  involved  in  the  primary  lesion. 

Atrophy  of  the  fibrillse,  and  consequent  fatty  degeneration 
of  their  contents,  is  often  due  to  pressure  by  an  inflammatory 
exudate  formed  in  the  spaces  of  their  connecting  areolar  tissue ; 
and  it  is  important,  practically,  to  remember  this,  for  the  reason 
that  the  sooner  an  exudate  can  be  removed,  the  less  chance 
there  is  of  degenerative  changes  taking  place  in  the  true  mus- 
cular elements. 

The  changes  that  occur  in  inflammation  of  muscular  tissue, 
whether  arising  from  strain  or  other  causes,  may  be  briefly  de- 
scribed thus: — Ist.  Swelling  from  congestion  and  exudation; 
2d.  Atrophy,  from  the  pressure  of  the  exudate  upon  the  muscu- . 
lar  fibrillse,  and  from  loss  of  function ;  od.  Fatty  degeneration  of 
the  sarcous  elements,  and  permanent  loss  of  contractility. 

Treatment. — Eepose;  soothing  applications,  succeeded  by 
slight,  and  afterwards  stronger  irritants.  Purgatives  and  cool- 
ing diet  at  first,  followed  by  good  nursing. 

STRAIN  OF  THE  PSO^  MUSCLES. 

Much  confusion  prevails  among  veterinary  surgeons  as  to  the 
proper  diagnosis  of  this  injury,  some  classifying  all  cases  of  in- 
ability, or  paralysis  of  the  hind  limbs,  unless  broken  back  can  be 
detected,  as  sprain  of  tlie  psooe  muscles ;  whilst  others  deny  the 
existence  of  such  an  injury  at  all. 

Sprain  of  the  psose  muscles  simulates  paralysis,  broken  back, 
and  that  mysterious  disease  which  has  been  erroneously  termed 
hysteria  by  Mr.  Haycock, — a  disease  which,  in  reality,  is  due  to 
the  presence  of  a  large  amount  of  effete  materials,  especially  urea, 
in  the  circulation,  and  which  may  be  termed  Azoturia. 

The  psoae  muscles — magnus  and  parvus — -are,  along  with  tlie 
iliacus,  sartorius,  &c.,  situated  within  the  pelvic  and  sub-lumbar 


STRAIN  OF  PSO^  MUSCLES.  243 

regions,  originating  at  the  heads  of  the  last  ribs  and  last  dorsal 
vertebrae,  extending  in  a  backward  direction  under  the  bodies  of 
the  lumbar  vertebrae  to  the  ilio-pectineal  eminence  on  the  brim 
of  the  pelvis,  and  the  internal  trochanter  of  the  femur.  Their 
action  is  to  bend  the  haunch  upon  the  pelvis,  to  draw  it  forward 
in  progression,  or  wliile  the  hind  quarters  are  stationary  and 
fixed  points,  their  action  produces  that  appearance  called 
"  roached  back." 

It  is  important  to  remember  the  action  of  these  muscles, 
for  when  injured  they  cease  to  act,  and  the  haunch  will  be 
thrown  into  the  opposite  condition  of  "  roached  back ; "  and 
from  this  circumstance  the  injury  may  be  readily  distinguished 
from  azoturia. 

Strain  of  these  muscles  is  caused  by  injury,  such  as  "  being 
cast  in  the  stall,"  or  by  any  other  accident  capable  of  producing 
violent  extension  of  them ;  hence  arises  the  difficulty  of  deter- 
mining between  it  and  "  broken  back."  It  may,  however,  be 
distinguished  from  the  paralysis  of  broken  back  by  the  power  of 
flexing  and  extending  the  limbs  being  still  retained  by  the  ani- 
mal whilst  it  is  lying  down ;  there  may  be  inability  to  rise  from 
the  ground,  as  the  psose  muscles  assist  very  materially  in  that 
operation  ;  but  when  raised  by  means  of  slings  from  the  recum- 
bent position,  and  when  the  hind  feet  are  firmly  placed  upon 
the  ground,  the  horse  is  able  to  stand  moderately  well,  and 
command  the  movements  of  the  limbs  to  some  extent,  although 
there  is  always  a  tendency  to  knuckling  over  at  the  fetlock- 
joints. 

The  muscles  of  one  side  may  be  injured ;  in  such  a  case  the 
loss  of  power  is  limited  to  one  side  only. 

If  the  injury  be  not  sufficiently  severe  to  destroy  the  power 
of  rising,  it  will  be  seen  that,  when  the  horse  is  made  to  walk,  he 
drags  his  limbs  or  trails  them  to  some  extent.  There  is  scarcely 
any  elevation  of  the  feet  or  flexion  of  the  joints,  and  a  great 
tendency  is  shown  to  knuckle  over  at  every  step. 

Examination  per  rectum  will  reveal  heat,  tenderness,  and 
swelling  under  the  spine  ;  and  in  the  majority  of  cases  that 
have  come  under  my  observation,  external  swelling  around  the 
rectum  and  perinseum,  or  vagina,  if  tlie  patient  be  a  mare,  will 
make  its  appearance  in  the  course  of  a  few  hours  after  the 
accident. 


244  LAMENESS. 

The  acute  inflammation  is  generally  succeeded  by  a  condi- 
tion of  atrophy,  and  for  some  time  afterwards  the  animal  will 
show  signs  of  weakness  and  inability  ;  but  these  wall  pass  away 
as  the  muscles  regain  their  power  and  tone. 

Treatment. — Eest  in  the  slings;  enemas,  to  act  as  internal 
fomentations ;  aperients,  and  febrifuges  if  fever  be  present. 
In  cases  w^here  the  appetite  is  not  much  impaired,  and  but 
little  or  no  fever  supervenes  upon  the  injury,  the  administra- 
tion of  medicine  should  be  wdthheld.  Fomentations  must  be 
applied  to  the  loins  and  perinaeal  region ;  and  after  the  first 
few  days,  mild  external  stimulants,  as  weak  ammonia  liniment, 
with  good  food  and  careful  tending.  It  may  be  laid  down  as  a 
general  principle  that  slings  do  harm  when  the  animal  is  unable 
to  stand  in  them,  and  if  both  fetlocks  knuckle  forwards,  and  the 
w^hole  weight  of  the  patient  be  thrown  upon  the  abdomen, 
slings  should  not  be  used ;  but  should  he  be  able  to  stand 
when  the  feet  are  implanted  on  the  ground,  the  slings  are 
very  useful.  After  some  time  has  elapsed,  and  when  the  patient 
appears  not  to  make  the  desired  progress  towards  recovery,  a 
good  blister  to  the  loins  and  quarters  will  be  very  beneficial,  and 
will  hasten  the  development  of  muscular  tissue.  If  the  season 
be  favourable,  a  run  at  grass  in  some  quiet  place  will  complete 
the  cure. 

Muscles  are  liable  to  become  deranged  in  their  function  either 
by  an  exaltation  or  depression  of  their  contractile  power,  and 
these  conditions  are  generally  exhibited  in  the  muscles  of  the 
lumbar,  gluteal,  and  femoral  regions. 

The  causes  of  these  aberrations  of  function  are  often  very 
obscure,  and  seldom  demonstrable.  It  has  been  already  pointed 
out  that  diseases  of  the  spinal  bones  are  present  during  life 
without  any  very  decided  external  manifestations;  and  from 
this  it  may  be  inferred  that  such  diseases  as  "  stringhalt," 
shivering,  or  that  form  of  partial  paralysis  vulgarily  termed 
*'■  jinked-back,"  as  well  as  that  peculiarly  obscure  nervo-muscular 
disease  called  by  French  veterinary  wrriters  "  immobilite,"  and 
by  English  horsemen  "  German  horses,"  are  all  probably  due  to 
some  disease  of  the  sensory  track  of  the  spinal  cord,  similar  to 
the  "  loco-motor  ataxia  "  of  the  human  patient,  which  is  thus 
described  by  Aitken  in  his  Science  and  Practice  of  Medicine, 
1866 : — "  In  the  erect  posture  the  muscles  may  sustain  a  heavy 


STRAIN  OF  PSOiE  MUSCLES.  245 

weight,  and  general  paralysis  does  not  supervene  for  months  or 
even  years.  There  is  then  a  gradual  and  progressive  loss  of  the 
power  of  co-ordination  in  the  acts  of  volition.  An  awkward 
unsteady  gait  is  the  earliest  indication  of  such  progressive  para- 
lysis. At  first  the  feet  are  moved  in  a  slatternly  manner,  the 
heels  lounging  on  the  ground,  and  then,  as  the  disease  advances, 
they  are  thrown  involuntarily  to  the  right  or  left  without  pur- 
pose, and  without  the  power  of  restraining  their  irregular  move- 
ments. The  act  of  turning  round  is  performed  with  great 
difficulty.  ...  If  the  patient  is  put  on  his  legs  with  his  eyes 
shut,  and  his  feet  close  together,  it  is  seen  that,  although  he  has 
the  muscular  power  he  has  not  the  muscular  sensibility  to  pre- 
serve his  body  from  falling,  or  to  guide  him  in  taking  even  a 
few  steps  forward  with  his  eyes  closed.  He  will  reel  and  tumble 
about  like  a  drunken  man." 

Functional  irregularity  of  muscular  action  may  arise  from 
granular  degeneration  of  the  muscles,  without  any  disease  being 
found  in  the  nerves  or  nervous  centres. 


CHOREA. 

Definition. — An  irregular  convulsive  clonic  action  of  the  volun- 
tary muscles,  confined  generally  in  the  horse  to  the  posterior 
extremities,  constituting  "  stringhalt,"  and  in  the  dog  as  a  sequel 
to  distemper,  to  the  anterior  ones,  neck,  and  face,  by  which  they 
are  withdrawn  from  the  control  of  volition. 

Many  pathological  views  are  entertained  regarding  this  dis- 
ease. By  some  it  is  regarded  as  entirely  functional,  and  inde- 
pendent of  organic  change.  By  others  it  is  held  that  it  is  due, 
at  least  in  some  cases,  to  some  disease  of  the  blood,  the 
precise  nature  of  which  is  as  yet  unknown,  and  that  it  may 
be  associated  with  some  diseases,  as  rheumatism  and  diseases  of 
the  heart. 

Professor  Dick  was  of  opinion  that  it  was  due  to  the  pre- 
sence of  tumours  in  the  lateral  ventricles  of  the  brain,  and 
supported  his  views  by  a  'post  mortem  proof.  But  tumours  in 
the  ventricles  may  be  present  without  chorea.-  and  chorea  is 
very  often  present  without  such  tumours.  Other  writers  have 
traced  its  origin  to  a  hypertrophied  condition  of  the  nerves 
given  off  from  the   lumbar  plexus,  to   the  pressure  of  some 


24G  LAMENESS. 

exostoses  on  a  nerve,  and  to  paralysis  of  the  muscles  antago- 
nistic to  those  affected  with  the  spasm.  In  one  case  which  fell 
under  my  notice,  melanosis  within  the  spinal  canal  was  the  cause 
of  chorea ;  but  the  spasm  (clonic,  or  rapidly  alternating  contrac- 
tions and  relaxations)  of  chorea  is  not  a  phenomenon  of  persis- 
tent spinal  irritation,  while  tonic  spasm  is  a  mark  of  such  a 
condition. 

Chorea  may  be  divided  into  partial,  as  in  stringhalt  in  the 
horse,  and  general,  as  seen  occasionally  in  dogs. 

Stringhalt  may  be  defined  to  be  an  involuntary  convulsive 
motion  of  the  muscles,  generally  those  of  one  or  both  hind  legs, 
but  occasionally  it  is  seen  in  the  fore  legs  also. 

The  limb  or  limbs  affected  are  convulsively  elevated  from 
the  ground,  and  brought  down  again  with  more  than  natural 
force.  It  is  not  always  to  be  noticed  at  every  step  the  horse 
takes.  He  may  go  several  paces,  as  many  as  twenty,  without 
exhibiting  any  signs  of  stringhalt ;  then,  all  at  once,  the  limb 
or  limbs  will  be  suddenly  elevated  from  the  ground  with  a 
peculiarly  sharp  sudden  jerk.  It  is  necessary  sometimes  to  turn 
the  animal  round  from  right  to  left,  and  from  left  to  right,  in 
order  to  make  him  show  any  signs  of  stringhalt,  the  symptoms 
of  the  disease  being  exhibited  as  he  turns  one  way  only.  It  is 
generally  developed  slowly,  but  I  have  seen  very  aggravated 
cases  come  on  in  one  night,  and  as  age  advances  it  always 
becomes  worse.  It  should  be  viewed  as  an  unsoundness,  and 
as  a  cause  of  depreciation  of  the  animal's  value.  In  two  horses 
which  had  suffered  from  very  violent  stringhalt,  the  2^ost  mortem 
examination  revealed  exostoses  on  the  shaft  of  the  ilium, 
involvinsf  the  o^reat  sciatic  nerves.  I  think  its  cause  is  sometimes 
peripheral,  as  when  a  bone-spavin  presses  upon  the  nerves  of 
the  hock.     The  stringhalt  then  is  due  to  reflex  nervous  action. 

In  grey  horses,  stringhalt  is  occasionally  due  to  a  deposition 
of  melanotic  material  in  the  sheath  of  the  great  crural  nerves.  I 
am  inclined  to  the  opinion  that  chronic  stringhalt,  or  that  form  of 
it  not  dependent  on  rheumatism,  arises  from  a  congested  condition 
of  the  nerves  and  their  sheaths,  and  that  there  is  always  a  tendency 
to  the  occurrence  of  neuritis  from  causes  that  would  otherwise 
have  no  effect  upon  the  nervous  system.  This  view  is  supported 
by  the  fact  that  injuries  to  the  feet,  or  any  part  of  tlie  limbs 
affected  with  stringhalt,  are  very  prone  to  be  succeeded  by  increase 
of  the  spasm,  by  much  nervous  excitement,  and  by  tetanus. 


CHOREA.  247 

Some  horses  affected  with  stringhalt,  when  injured  in  the 
feet,  become  almost  unmanageable  from  the  extent  of  the  spasm; 
they  are  soon  exhausted  by  the  expenditure  of  nervous  and 
muscular  force,  and  the  mortality  from  such  injuries  is  much 
greater  than  in  horses  free  from  stringhalt. 

There  is  no  treatment  in  chronic  stringhalt.  I  have  divided 
the  tibial  nerves  when  it  has  been  associated  with  bone-spavin. 
In  this  case  it  was  confined  to  one  leg  only,  and  to  a  fearful  ex- 
tent, the  foot  being  caught  up  with  extreme  rapidity,  and  brought 
down  with  great  violence,  insomuch  that  the  shoe  was  repeatedly 
broken  by  the  violence  of  the  concussion.  There  was  a  bone- 
spavin  on  the  hock,  with  considerable  heat  and  tenderness. 
After  trying  various  remedies  upon  the  hock  without  good 
result,  I  divided  the  tibial  nerves ;  but  the  animal  derived  no 
benefit  from  the  operation.  In  aggravated  cases  the  limbs  are 
adducted,  the  foot  thrown  outwards,  as  well  as  elevated,  during 
the  act  of  progression.  But  where  the  symptoms  are  aggravated 
from  any  cause — such  as  an  injury,  common  cold,  or  other  source 
of  febrile  disturbance — the  severity  of  the  spasmodic  action  may 
be  much  modified  by  removal  of  the  cause  of  excitement,  and  by 
a  cathartic,  belladonna,  or  the  bromide  of  potassium,  in  suitable 
doses.  Hard  work  will  very  often  increase  stringhalt  to  such  an 
extent  as  to  call  for  medical  treatment.  In  the  rheumatic  form 
the  treatment  for  rheumatism  is  to  be  prescribed. 


IMMOBILITE,  SHIVERIXG,  SPRAINED  BACK,  ETC. 

Immobilite  is  a  term  applied  by  French  veterinarians  to 
those  cases  of  muscular  irregularity  manifested  by  the  inability 
of  the  horse  to  turn  round  quickly  without  falling.  He  may 
be  able  to  trot  in  a  straight  line  well  enough,  but  when  turned 
round  sharply,  immediately  falls.  A  modified  form  of  this 
disease  is  very  often  encountered  when  the  animal,  although 
able  to  turn  without  falling,  does  so  with  great  difficulty, 
throwing  the  hind  legs  about  in  an  awkward,  unsteady  manner, 
and  seemingly  without  power  to  regulate  their  movements ;  the 
hind  quarters  reeling  from  side  to  side,  clearly  showing  that 
the  muscular  movements  are  imperfectly  controlled  by  the 
power  of  volition. 

This  is  commonly  called  broken,  sprained,  or  jinked  back  by 


248  LAMENESS. 

horsemen.  It  is  not  due  to  any  fracture,  nor  always  to  any 
external  injury,  but  is  a  progressive  disease,  arising  from  some 
alteration  of  structure  in  the  spinal  cord  from  disease  of  the 
vertebra,  or  from  granular  degenerative  disease  of  the  muscles 
themselves. 

"  Shivering  "  is  another  peculiar  nervo-muscular  affection  of 
the  posterior  extremities,  resembling  stringhalt,  and  manifested 
more  particularly  during  the  acts  of  "  backing "  or  "  turning 
reund." 

In  a  case  of  this  kind  the  animal,  when  made  to  back,  wiU 
perform  that  act  with  some  difficulty;  the  muscles  of  the 
gluteal  and  femoral  regions  are  thrown  into  a  state  of  "  clonic 
spasm,"  contracting  and  relaxing  in  a  very  irregular  manner; 
hence  the  term  "  shivering,"  from  the  resemblance  of  the  mus- 
cular action  to  trembling  or  shivering.  In  many  cases  the 
tail  is  spasmodically  elevated  and  depressed  in  the  manner  of 
a  pump-handle,  and  the  limbs  elevated  from  the  ground  by  a 
peculiar  rigid  or  stiff  movement ;  the  foot  often  suspended  for 
a  moment,  as  if  the  animal  were  unable  to  direct  the  action  of 
the  muscles. 

When  moved  forwards,  the  necessary  actions  will  be  per- 
formed tolerably  wxll,  but  the  backward  movement  is  done  with 
more  or  less  difficulty,  and  sometimes  it  cannot  be  performed 
at  all. 

Shivering,  immohilite,  strained  back,  and  their  various  modi- 
fications, must  be  considered  as  causes  of  unsoundness,  since 
their  tendency  is  to  increase  in  severity  as  the  animal  becomes 
older.  They  often  interfere  with  his  condition,  and  generally 
give  him  an  aged  appearance  before  he  has  reached  his  prime ; 
and  they  prevent  him  lying  down,  particularly  if  he  is  confined 
in  a  stall.  Some  horses,  while  so  affected,  lie  down  well 
enough ;  the  majority,  however,  scarcely  ever  do  so,  but  fall 
down  in  their  sleep  occasionally,  and  being  unable  to  rise 
again  without  assistance,  often  injure  themselves  by  strugghng. 
Animals  of  this  kind  should  always  be  slung  at  night. 

Hereditary  tendency. — I  think  there  can  be  no  doubt  as  to 
hereditary  predisposition  being  one  of  the  causes  of  the  fore^ 
going  diseases ;  indeed,  I  have  had  sufficient  proof,  in  my  own 
experience,  to  convince  me  that  such  is  the  case.  Very  often 
one  form  or  other  will  be  found  in  young  animals,  two  or  three 


IMMOBILITE,  ETC.  249 

years  old,  that  have  been  subjected  to  no  hardship,  arising 
spontaneously,  and  increasing  by  slow  degrees.  I  have  one 
instance  on  record  where  four  young  horses,  the  progeny  of  a 
dam  that  was  affected  in  the  back,  died  from  spinal  paralysis 
before  they  had  attained  the  age  of  three  years.  A  fifth  is  now 
living,  and  shows  signs  of  aggravated  nervo-muscular  disease. 


MYOSITIS,  OR  INFLAMMATION  OF  MUSCULAR  STRUCTURE. 

The  muscles  may  be  inflamed,  either  from  external  or  internal 
causes,  those  of  the  lumbar  and  gluteal  regions  being  most 
generally  so  affected.  The  intrinsic  cause  of  myositis  is  the 
presence  of  the  rheumatic  poison  in  the  blood ;  and  the  extrinsic 
causes  are  sprains,  the  application  of  direct  violence,  or  of 
cold  and  moisture.  It  is  expressed  by  pain,  swelling,  heat,  and 
loss  of  function.  Inflammation  of  the  muscles  of  the  dorsal, 
lumbar,  and  gluteal  regions  has  often  been  confounded  with 
"laminitis;"  but  a  careful  practitioner  need  not  make  such  a 
mistake. 

In  laminitis,  as  well  as  myositis,  there  is  great  stiffness.  In 
laminitis  there  is  a  tendency,  more  particularly  in  the  hind  feet, 
to  elevate  the  feet  from  the  ground  alternately.  In  myositis 
there  is  no  such  tendency,  the  feet  being  firmly  planted  on  the 
ground,  and  there  allowed  to  remain,  if  the  animal  be  not  forcibly 
moved.  In  laminitis,  when  the  animal  is  down,  the  symptoms 
of  fever  and  pain  are  considerably  alleviated.  In  inflammation 
of  the  muscles  there  is  no  tendency  to  lie  down;  and  if  the 
animal  were  forcibly  cast,  as  is  sometimes  done  in  laminitis,  the 
symptoms  will  become  aggravated.  A  horse  with  fever  in  his 
hind  feet  will  generally,  immediately  on  rising,  begin  to  shift 
them,  become  very  uneasy,  much  distressed,  and  at  last  will  lie 
down  with  a  sigh  of  relief ;  the  pulse  falling,  in  the  course  of  a 
few  minutes,  perhaps  thirty  to  forty  beats  per  minute. 

In  some  cases  of  laminitis  there  is  a  disinclination  to  lie 
down ;  but  when  such  are  forcibly  laid  on  a  comfortable  bed, 
they  generally  feel  inclined  to  remain  recumbent,  and,  as  a  rule, 
it  is  only  necessary  to  lay  them  down  once  or  twice  before  they 
find  out  the  benefit,  and  take  advantage  of  it  without  assistance. 

When  the  muscles  of  the  loins  and  quarter  are  inflamed  the 
symptoms  will  simulate  those  of  stringhalt. 


250  LAMENESS. 

I  have  merely  pointed  out  these  essential  marks  of  difference 
at  present ;  a  more  detailed  account  of  laminitis  will  be  given 
hereafter. 

The  treatment  of  muscular  inflammation,  when  not  caused  by 
such  a  degree  of  violence  as  to  destroy  the  vitality  of  the  parts, 
is  very  simple, — a  gentle  purgative,  rest,  fomentations.  Should 
atrophy  succeed  the  active  stage,  a  mild  blister. 


RHEUMATIC  LAMENESS. 

The  lameness  is  characterised  by  what  is  termed  metastasis, 
or  a  shifting  of  the  seat  of  the  disease  from  one  part  to  another. 
The  favourite  seats  of  rheumatism,  occurring  after  influenza,  are 
the  sesamoid  bursas ;  but  it  may  appear  in  almost  any  serous  or 
synovial  structure.  It  is  not  my  intention  here  to  enter  into 
the  pathology  of  rheumatism,  that  being  reserved  for  another 
volume;  but  I  may  lay  down  a  simple  rule  for  its  treatment. 
A  strong  vesicating  blister  should  be  applied  to  the  part  and 
around  it  without  loss  of  time,  all  other  local  applications  being 
in  my  opinion  worse  than  useless.  A  blister  is  supposed  to  act 
by  attracting  the  rheumatic  poison  into  its  vesicles,  and  removing 
it  from  the  system  by  the  bursting  of  such.  It  is  recom- 
mended by  Dr.  Eichardson  and  others  that  the  blister  should 
be  near,  but  not  upon,  the  diseased  spot ;  but  I  have  found  this 
inconvenient,  and  a  direct  aj)plication  to  answer  every  purpose. 

A  horse  suffering  the  greatest  agony  from  rheumatism  is  re- 
lieved in  the  course  of  one  day,  provided  a  numerous  crop  of 
vesicles  be  produced.  The  cantharides  blister  is  the  best;  a 
purgative  is  useful  after  the  blister.  If  the  lameness  be  not 
thus  removed,  colchicum  and  nitrate  of  potash  are  to  be  adminis- 
tered ;  and  if  these  fail,  the  iodide  of  potassium,  or  carbonate  of 
soda  or  potash,  with  vegetable  tonics. 

In  dogs,  rheumatism  is  commonly  called  Kennel  Lameness. 

It  attacks  young  sporting  dogs  more  frequently  than  any 
other  class.  The  cause  is  usually  to  be  found  either  in  the 
construction  of  the  kennels  or  their  management ;  damp  or  cold 
situations,  bad  drainage,  a  short  supply  of  clean  straw,  and  want 
of  exercise,  are  each  and  all  liable  to  produce  this  intractable 
disease.  The  symptoms  are  general  rigidity,  accompanied  with 
great  pain,  as  evinced  by  the  anxious  expression,  hurried  breath- 


RHEUMATIC  LAMENESS.  251 

ing,  disinclination  to  move,  and  pain  on  manipulation;  tlie 
pulse  is  hard  and  quick.  The  tendency  of  the  disease  is  to 
localise  itself  in  the  joints,  attacking  one  or  more  at  first,  dis- 
appearing from  there,  and  appearing  in  others. 

Treatment. — Put  the  patient  in  a  dry  warm  place,  and  ad- 
minister an  aperient.  Great  relief  will  be  obtained  by  immer- 
sion in  warm  baths  ;  care  being  taken  to  prevent  chill  afterwards. 
The  affected  joints  are  to  be  stimulated  with  soap  liniment; 
alkalies,  diuretics,  and  nourishing  but  easily  digested  food,  are  to 
be  given ;  and  when  the  more  acute  symptoms  have  passed  off, 
citrate  of  quinine  and  iron. 

The  terms  rheumatism  and  rheumatic  lameness  are  often  mis- 
applied. For  example,  scrofulous  disease  of  the  joints  in  horned 
cattle  is  commonly  thought  to  be  rheumatic  in  its  character,  and 
due  to  external  causes,  such  as  cold,  damp,  &c. ;  whereas,  in 
reality,  it  is  an  intrinsic  disease,  and  due  in  the  great  majority 
of  instances,  more  especially  when  it  occurs  amongst  high-bred 
stock,  to  a  system  of  in-and-in  breeding  persisted  in  for  too  long 
a  period.  Again,  a  disease — osteo-malacia — often  terminating  in 
spontaneous  fracture  of  the  bones,  which  prevails  amongst  horned 
cattle  pastured  on  poor  land,  and  occurring  mostly  during  dry 
summers,  is  supposed  to  be  of  rheumatic  origin,  whilst  in  reality 
the  stiffness  of  the  joints  and  lameness  are  symptomatic  of  mal- 
condition  of  the  body  generally,  and  of  the  osseous  system  parti- 
cularly, due  to  the  want  of  proper  food  in  sufficient  abundance, 
or  to  something  deleterious  in  it.  In  Wales  this  disease  is  sup- 
posed to  be  caused  by  the  animals  eating  the  purging  or  mountain 
tlax  {Linitm  Catliarticuni),  which  is  found  growing  amongst  the 
pastures  in  such  situations.  I  cannot  endorse  the  popular  idea 
that  this  plant  is  the  cause,  for  cattle  refuse  to  eat,  indeed,  turn 
away  from  it.  I  look  upon  it  more  as  an  evidence  that  the  land 
is  poor,  and  the  pastures,  particularly  in  very  dry  seasons,  defec- 
tive in  nutritious  elements. 

The  symptoms  are  depravity  of  the  appetite,  rapid  emaciation, 
venous  murmurs ;  stiffness  of  the  limbs,  swelling  of  the  joints, 
and  difficulty,  or  even  inability,  in  rising  from  the  recumbent 
position. 

The  post  mortem  appearances  are  remarkable.  The  whole 
body  is  wasted,  the  muscles  anaemic  and  flabby,  the  blood  is  thin 
and  watery,  and  the  tissues  are  oedematous  and  softened. 


252  LAMENESS. 

Parasites  are  often  present  in  large  numbers  in  the  stomacli 
and  intestines.  The  bones  are  enlarged  and  softened,  crumble 
upon  the  application  of  slight  pressure,  and  if  fractures  have  oc- 
curred some  time  prior  to  death,  it  will  be  found  that  the  repara- 
tive process  has  been  but  very  imperfectly  and  feebly  established. 

In  this  disease  a  peculiar  pathological  process  obtains,  similar 
to  that  which  is  witnessed  in  the  general  emaciation  of  phthisis 
pulmonalis,  described  at  page  49  of  my  Principles  and  Practice 
of  Veterinary  Medicine,  namely,  the  absorption  of  a  tissue,  and 
its  redeposition ;  but  in  this  disease,  instead  of  fat  being  absorbed, 
it  is  found  that  the  calcareous  ingredients  of  some  bones  are 
removed  by  absorption,  and  deposited  in  the  form  of  osseous 
tumours  upon  various  other  bones  of  the  skeleton,  obliterating 
cavities  of  reception,  and  causing  deformity  of  the  bones  them- 
selves. 

The  prevention  of  this  disease  is  to  be  accomplished  by 
proper  diet ;  change  of  pasture  if  possible,  if  not,  the  addition  of 
cake  or  other  nutritious  feeding  material;  whilst  the  pastures 
themselves  are  to  be  manured  with  artificial  and  other  dressings 
— the  phosphates  of  lime,  nitrate  of  soda,  or  the  salts  of  ammonia, 
as  may  be  determined  upon  by  a  competent  analyst. 

In  the  early  stages,  the  disease  may  be  successfully  combated 
by  antacids,  tonics,  occasional  but  mild  aperients,  and  proper 
food ;  but  if  the  osseous  system  is  greatly  involved,  treatment  is 
uselesa. 


CHAPTER  XIIL 

PARTICULAR    LAMENESSES. 

SHOULDER    LAMENESS — SHOULDER  -  SLIP — ELBOW     LAMENESS — SPRAIN 
OF  RADIAL  OR  SUPERIOR  CARPAL  LIGAMENT — CARPITIS. 

SHOULDER  LAMENESS. 

There  are  three  forms  of  shoulder  lameness,  which  may  exist 
independently  of  each  other.  One  of  them  is  illustrated  in 
Photo-lithograph,  Plate  II.,  Pig.  1.  These  three  causes  are — 
(1st.)  Disease  of  the  shoulder-joint.  Photo-lithograph,  Plate  III., 
Fig.  1 ;  (2d.)  Sprain  of  the  flexor  brachii,  Photo-lithograph, 
Plate  I.,  Fig.  5 ;  and  (3d.)  Sprain  of  the  antea  and  postea 
spinati,  teres  major  and  minor,  muscles,  but  more  particularly 
of  the  spinati,  as  they  are  mostly  concerned  in  performing  the 
function  of  binding  ligaments,  connecting  the  scapula  and  the 
humerus. 

Mr.  Percivall  and  others  were  of  opinion  that  injury  to  the 
serratus  magnus  was  a  frequent  cause  of  shoulder  lameness. 
Professors  Dick  and  Barlow  taught  that  such  could  hardly 
be  the  case,  and  my  experence  leads  me  to  endorse  their 
opinion. 

The  three  above  mentioned  are  the  usual  causes,  but  there 
are  others  sometimes  met  with,  namely,  rheumatism;  liver 
disease  ;  formation  of  abscesses  in  the  brachial  glands,  as  a 
sequence  to,  or  sometimes  a  primary  manifestation  of  strangles ; 
open  joint  and  necrosis  of  scapula. — (See  Photo-lithograph,  Plate 
I,  I'ig.  6.) 

Disease  of  the  Shoulder-Joint  may  arise  from  a  variety  of 
causes,  as  sprains  or  rheumatism.  Inflammation  having  been 
set  up  in   the  structures  of  the  joint;  the  capsular  ligament 


254  PARTICULAR  LAMENESSES. 

becomes  thickened,  in  other  parts  diminished,  in  structure  ; 
distended  by  synovia  and  exudation;  the  articular  cartilage 
is  removed  by  ulceration,  or,  in  rheumatoid  disease,  converted 
into  the  porcellaneous  deposit;  the  capsular  ligament  and 
synovial  membrane,  with  its  fringes,  becoming  at  the  same  time 
loaded  with  calcareous  matter. — (See  Photo-lithograph,  Plate 
II.,  Fig.  1.)  When  the  cartilage  is  ulcerated,  there  is  caries 
of  the  heads  of  both  scapula  and  humerus,  and  afterwards 
anchylosis  of  the  articulation. — (See  Photo- lithograph,  Plate  III., 
Pig.  1.) 

At  one  time  all  obscure  lamenesses  in  the  fore  extremity 
w^ere  attributed  to  the  shoulder,  and  one  heard  of  nothing  but 
shoulder  lameness.  A  reaction,  however,  took  place,  after 
Turner  re-discovered  navicular  disease,  in  favour  of  the  latter, 
which  for  many  years  bore  the  palm ;  but  now  these  extreme 
views  have  been  much  modified,  although  there  are  still  some 
who  attribute  everything  to  the  foot,  and  others  to  the  shoulder. 
It  must  be  understood,  however,  that  there  are  shoulder  as  well 
as  foot  lamenesses,  and  a  proper  diagnosis  must  be  made  of 
each  case  by  the  practitioner,  who,  if  enlightened,  never  weds 
liimself  to  the  one  theory  or  the  other,  but  is  guided  by  such 
facts  as  present  themselves  to  his  notice. 

Diagnosis. — The  gait  of  shoulder  lameness  is  indicative  of 
the  seat  of  disease.  The  patient  does  not  carry  his  limb 
straight  forward,  but  with  a  rotatory  motion,  the  limb  being 
thrown  outwards,  and  the  toe  made  to  form  the  segment  of  a 
circle ;  in  other  words,  he  brings  the  leg  forward  with  a  sort  of 
sweep,  and  in  some  cases  the  toe  of  the  foot  is  dragged  or 
trailed  along  the  ground.  In  shoulder  and  knee  lameness  more 
particularly,  the  signs  of  pain  are  more  discernible  during  the 
elevation  of  the  foot  from  the  ground ;  whereas  in  foot  and  other 
diseases  below  the  knee,  the  converse  is  the  rule. 

Upon  manipulation,  it  will  be  discovered  that  pain,  heat,  and 
swelling  are  present.  In  order  to  discover  the  swelling,  it  will 
be  necessary  to  push  the  levator  humeri  muscle  to  one  side.  It 
is  but  loosely  attached  to  the  shoulder  joint,  which  it  covers. 
The  next  test  is  to  take  hold  of  the  limb,  and  move  it  backward 
and  forward,  to  perform  flexion  and  extension,  when  the  animal 
will  shrink,  and  evince  considerable  pain.  In  some  well-marked 
cases  the  extension  of  the  fore  arm  by  the  examiner  will  cause 


SHOULDER  LAMENESS.  255 

tlie  animal  to  rise  bodily  from  the  ground.  It  must,  however, 
be  always  understood  that  uneasiness  when  these  move- 
ments are  performed,  or  when  the  shoulder  is  pressed  upon, 
is  of  itself  insufficient  to  determine  the  seat  of  lameness,  as 
many  horses  are  fidgety,  and  will  not  bear  such  handling. 
But  if  there  be  a  drag  in  the  gait,  along  with  the  other 
signs,  it  may  fairly  be  concluded  that  the  case  is  one  of 
shoulder  lameness. 

Sprain  of  the  Flexor  Bracliii. — This  muscle  contains  a  large 
amount  of  tendinous  fibres,  and  is  entirely  tendinous  as  it  passes 
over  the  bicipital  groove  in  front  of  the  superior  extremity  of 
the  humerus,  over  which  it  plays  like  a  rope  over  a  pulley, 
becoming  inserted  finally  into  the  inner  head  of  the  radius. 
Both  it  and  the  groove  are  lined  with  fibro-cartilage,  and 
enclosed  w^ithin  a  synovial  sac.  It  extends  from  the  sca- 
pula to  the  head  of  the  radius,  and  its  function  is  to  flex 
the  fore  arm  upon  the  shoulder, — an  important  function,  ren- 
dering the  structures  which  perform  it  liable  to  injury  and 
disease. 

In  sprain  of  the  flexor  brachii,  the  muscle,  along  nearly  all 
its  course,  will  be  found  swollen  and  inflamed,  standing  out 
prominently  from  the  surrounding  structures.  This  swelling, 
along  with  that  of  the  bursa  in  front  of  the  shoulder,  pain  upon 
pressure,  and  the  gait  peculiar  to  shoulder  lameness,  namely,  a 
difficulty  in  elevating  the  foot  from  the  ground,  are  the  diagnostic 
symptoms. 

It  might  be  supposed  that  disease  of  the  bicipital  groove 
would,  from  contiguity  of  situation,  be  always  accompanied  by 
disease  of  the  shoulder-joint  itself;  but  such  is  not  the  case, 
as  may  be  seen  from  an  examination  of  Photo-lithograph, 
Plate  I.,  Fig.  5.  In  many  cases,  however,  the  joint  becomes 
affected. 

The  result  of  sprain  of  the  flexor  brachii  is  inflammation  of 
the  tendon  and  the  structures  of  the  bursa,  which,  if  not  arrested, 
will  run  on  to  ulceration  of  the  cartilage  upon  the  tuberosities  of 
the  humerus,  to  caries  of  the  bone,  degeneration  and  rupture 
of  the  tendinous  fibres,  and  finally  to  ossification  of  the  whole 
substance  of  the  muscle  and  tendon.  The  reason  why  ossifi- 
cation, and  not  atrophy,  as  in  inflammation  of  other  muscles, 
must  be  looked  for,  is  the  fact  that  the  flexor  hrachii  is  mostly 


256  PARTICULAR  LAMENESSES. 

composed  of  tendinous  fibres,  and  long-continued  inflammation 
of  tendons  usually  ends  in  their  ossification. 

The  causes,  like  those  of  the  next  variety,  are  generally  due 
to  the  horse  being  worked  at  the  plough,  and  on  the  off  side, 
by  which  his  limbs  and  shoulders  are  thrown  into  an  irregu- 
larity of  position;  that  is  to  say,  one  foot  is  placed  in  the 
furrow,  and  the  other  on  the  land.  One  shoulder  is  thus  in  a 
lower  position  than  its  fellow,  an  extra  amount  of  weight  being 
at  the  same  time  thrown  upon  it,  so  that  in  the  course  of  time 
its  structures  become  diseased. 

Sprain  of  the  flexor  brachii  from  the  above  cause  is  confined 
generally  to  the  off  side,  and  this  can  be  easily  understood  from 
the  extra  w^ork  it  has  to  perform  in  elevating  the  foot  which  is 
in  the  furrow  to  the  level  of  that  which  is  on  the  land.  Plough- 
ing is  not  the  only  cause  of  this  form  of  lameness  ;  but  a  horse 
that  has  been  sprained  in  this  tendon  is  seldom  fit  for  the  plough 
ao-ain.  He  may  work  on  the  road  well  enough ;  but  as  soon  as 
he  is  put  in  the  plough  the  lameness  returns.  In  some  instances 
rheumatism  becomes  localised  in  the  flexor  brachii,  and  is  a  cause 
of  intermitting  lameness. 

In  the  treatment  of  both  shoulder-joint  and  flexor  brachii 
lameness,  great  advantage  is  derived  from  the  application  of  the 
hif^h-heeled  shoe.  This  enables  the  horse,  while  standing,  to 
have  the  diseased  structures  in  a  state  of  relaxation  and  repose. 


"  SHOULDER-SLIP. 

By  this  is  meant  that  peculiar  outward  slipping  movement 
of  the  shoulder-joint  at  each  step  the  animal  takes  when  the 
foot  of  the  lame  limb  is  upon  the  ground,  the  opposite  one 
elevated  from  it,  and  when  the  weight  of  the  horse  is  thus  thrown 
upon  the  lame  side. 

It  would  appear  almost  as  if  the  shoulder  were  out  of  joint, 
hence  the  term  "  shoulder-slip ;"  but  such  is  not  the  case,  as  the 
following  observations  will  explain. 

The  scapula  and  humerus  are  not  bound  together  by  lateral 
or  binding  ligaments,  as  is  the  case  with  other  joints,  the 
movements  between  them  being  so  varied  and  extensive,  that 
inelastic  ligaments  would  not  allow  them  to  be  performed. 
They   are    consequently   bound   together   by   muscles,  which 


SHOULDER-SLIP.  257 

perform  the  function  of  ligaments,  and  admit  of  a  variety 
and  extent  of  motion  by  their  power  of  contraction  and  re- 
laxation. 

These  muscles  are  the  antea  and  postea  spinatus  and  teres  ex- 
ternus.  The  spinati,  which  are  mostly  concerned  in  this,  are 
lodged  in  the  fossse  of  the  scapula,  covering  its  whole  external 
surface,  and  attached  inferiorly  to  the  tuberosities  and  ridge  of 
the  humerus,  and  to  the  capsular  ligament  of  the  shoulder- 
joint.  It  will  be  seen  from  their  position  that  their  action  is 
mainly  to  prevent  the  outward  bulging  of  the  head  of  the 
humerus,  to  keep  the  parts  firmly  and  closely  in  their  respec- 
tive situations,  and  to  assist  in  the  elevation  and  adduction  of 
the  humerus. 

It  will  be  remembered  that  there  is  great  disparity  between 
the  articular  head  of  the  humerus  and  the  glenoid  cavity  of 
the  shoulder,  the  latter  being  much  smaller  than  the  former. 
This  disparity  of  size  allows  a  liberty  of  motion  without  dis- 
location that  otherwise  would  be  impossible,  assisted  and 
kept  within  moderate  bounds  by  the  action  of  the  foregoing 
muscles. 

This  form  of  lameness  is  generally  seen  in  horses  that  are 
worked  in  the  plough,  and  in  the  horse  that  works  in  the 
furrow.  Mr.  Barlow  said,  "  alwa3^s  in  the  limb  that  is  placed 
in  the  furrow ;"  but  I  cannot  endorse  this,  having  often  seen  it 
in  both  shoulders. 

The  explanation  is,  I  think,  simple,  the  functions  of  the 
muscles  being — 1st.  To  keep  the  parts  firmly  together ;  2d.  To 
prevent  the  outward  bulging  of  the  head  of  the  humerus ;  ?>cl. 
To  draw  the  head  of  humerus  outwards  when  the  glenoid  cavity 
overlaps  its  outer  border ;  and  4:th.  To  assist  in  lifting  the  limb. 
!N'ow,  when  the  limb  is,  as  it  were,  made  longer  than  its  fellow, 
by  the  foot  being  placed  upon  lower  ground  in  the  furrow,  it 
necessarily  follows  that  the  work  to  be  performed  by  these 
muscles  is  increased  to  a  considerable  extent,  as  the  limb  seems 
to  hang  from  the  shoulder ;  and  that,  in  consequence,  the  demand 
upon  them  is  beyond  their  power  of  endurance.  Inflammation 
is  excited  in  the  muscular  structure,  and  often  in  the  tendons  ; 
the  exudation  presses  upon  the  true  sarcous  fibrillse,  which,  along 
with  degradation  of  their  constituent  elements  consequent  upon 
the  injury,  leads  on  to  atrophy. 

s 


258  PARTICULAR  LAMENESSES. 

A  muscle,  when  inflamed,  or  when  atrophied,  loses  its  power 
of  contractility  and  its  tone  ;  and  in  this  form  of  lameness  the 
shoulder  bulges  outwards  when  the  weight  of  the  animal  is 
thrown  upon  the  lame  side,  because  the  muscles  which  bind  the 
shoulder,  and  limit  the  great  extent  of  motion  between  the 
scapula  and  humerus,  are  no  longer  able  to  perform  their 
functions.  So  much  then  for  the  shoulder  of  the  off  side  limb ; 
and  we  must  now  endeavour  to  explain  how  "shoulder-slip" 
can  occur  in  the  near  side,  or  that  which  is  placed  upon  the 
land,  and  higher  than  its  fellow  during  ploughing. 

The  second  function  of  these  muscles  is  to  prevent  the  out- 
ward bulging  of  the  shoulder-joint,  more  particularly  the  head  of 
the  humerus, — a  condition  of  the  joint  which  occurs  always 
when  a  limb  is  placed  upon  higher  ground  than  its  fellow,  as 
any  one  might  see  by  watching  a  horse  working  in  the  plough. 
There  is  a  bulging  outward,  a  contortion  in  fact,  at  every  step 
the  animal  takes ;  the  parts  are  thrown  out  of  their  equihbrium, 
first  into  a  state  of  undue  relaxation,  by  the  upward  pressure  of 
the  humerus,  then  of  undue  extension,  by  the  outward  bulging. 
Again,  both  fore  feet  may  be  occasionally  in  the  furrow,  and 
the  hind  ones  also.  This,  with  slipping  in  and  out,  and  the 
inequality  of  the  land,  brings  on,  particularly  in  the  young  horse, 
a  state  of  irritation  which  finally  terminates  in  inflammation 
and  atrophy. 

It  is  seldom  that  any  but  young  horses  suffer  from  this  lame- 
ness, as  older  horses  become  used  to  their  work,  and  are  able 
to  avoid  injuring  themselves.  Great  care  is  therefore  required 
in  bringing  the  young  horse  gradually  to  his  work, — in  fact,  "  to 
break  him  in  "  with  due  caution,  by  placing  him  at  the  side  of 
a  steady,  quiet  old  horse ;  one  that  will  not  outpace  him,  nor 
fatioue  him  in  his  work.  When  an  animal  becomes  fatigued 
he  loses  command  over  his  action,  becomes  unsteady  in  his  gait, 
and  is  thus  rendered  liable  to  sprain  himself. 

Sj/mjjtoms. — In  some  cases  there  will  be  swelling  and  heat 
over  the  course  of  the  muscles,  upon  the  outer  surface  of  the 
scapula,  and  in  the  joint  itself;  but  in  the  majority  of  cases 
actual  lameness  does  not  occur  until  the  muscles  have  become 
considerably  atrophied,  and  instead  of  swelling,  there  will  be 
a  wasting  of  the  shoulder.  There  will  be  a  hollow  space  upon 
either  side  of  the  scapular  spine,  extending  its  whole  length. 


SHOULDER-SLIP.  259 

The  spine  is  thus  rendered  prominent,  standing  out  as  a  sharp 
ridge  from  its  surrounding  structures.  By  standing  in  front  of 
the  horse,  if  one  shoulder  only  is  affected,  and  by  comparing  the 
two  shoulders,  the  difference  can  at  once  be  detected.  If  both 
are  diseased,  this  comparison  will  not  be  of  any  service,  but  it  is 
seldom  that  they  are  both  alike ;  in  one,  the  antea  spinatus,  in 
the  other,  the  postea  spinatus,  is  the  more  atrophied.  This 
atrophy  is  different  from  that  wasting  of  the  shoulders  seen  in 
chronic  foot  lameness.  In  the  one  case,  the  muscles  of  the 
external  surface  of  the  scapula  only  are  wasted ;  whilst  in  the 
other,  all  the  muscles  of  the  shoulder  and  arm  are  in  that 
condition. 

Shoulder-slip  is  curable,  provided  the  tendons  of  the  muscles, 
the  rim  of  the  glenoid  cavity  of  the  scapula,  or  the  external 
trochanter  of  the  humerus,  be  not  organically  altered  in  struc- 
ture. The  alterations  found  in  these  are  abrasion  of  the  tendons, 
ulceration  of  the  cartilage  covering  the  bones  over  which  they 
glide,  and  caries  of  the  bones  themselves. 

Treatment. — During  the  inflammatory  stage,  purgatives,  fomen- 
tations, removal  of  shoes,  and  rest.  After  the  muscles  are  wasted, 
repeated  applications  of  moderate  stimulating  remedies,  such  as 
mild  blisters,  and  a  long  period  of  rest  in  a  strawj^ard,  or  at  grass. 
When  recovered,  the  patient  should  be  put  to  other  work  than 
ploughing. 

Some  dealers  have  no  objection  to  horses  with  wasted  shoul- 
ders if  they  go  sound,  as  it  is  well  known  that  they  will  perform 
their  work  well  enough  if  not  put  to  the  plough.  Notwith- 
standing this,  I  hold  that  it  is  an  unsoundness  in  law,  and  that 
it  always  depreciates  the  animal's  value.  I  have  seen  many 
young  carriage-horses  suffer  from  this  form  of  unsoundness, 
resulting  from  working  in  the  plough ;  but  I  cannot  recollect 
one  instance  where  they  were  rendered  permanently  unfit  for 
carriafTe  work. 

This  fact  is  important,  if  it  become  the  universal  law  that  un- 
soundness means  unfitness  for  work.  I  mention  this  because  I 
have  heard  lawyers  argue  and  judges  rule  that  such  is  the  "  law 
of  warranty." 

It  might  be  supposed  that  the  atrophy  of  the  muscles  of  the 
shoulder,  which  is  so  well  marked  in  this  form  of  lameness,  only 
became  apparent  after  a  considerable  interval  had  elapsed  subse- 


2C0  PARTICULAR  LAMENESSES. 

quent  to  the  sprain  of  the  muscles.  Such,  however,  is  not  the 
case;  and  it  may  be  laid  down  as  a  fact  that  well-developed 
atrophy  occurs  in  the  course  of  three  weeks  after  a  sound  horse 
has  been  put  to  work ;  and  in  many  instances  it  seems  the  altera- 
tion has  been  due  to  an  irritation,  not  amounting  to  inflamma- 
tion, leading  directly  to  mal-nutrition,  without  the  occurrence  of 
swelling  or  exudation. 

When  shoulder  lameness  arises  from  disease  of  the  liver,  it 
occurs  in  the  off  side  only,  and  is  associated  with  loss  of  appetite 
and  yellowness  of  the  mucous  membranes. 

Abscesses  in  the  brachial  or  pre-scapular  ganglia  of  the  Ijon- 
phatic  glands  may  be  the  cause  of  lameness  in  the  shoulder. 
These  glands  are  situated  between  the  scapula  and  thoracic  walls, 
and  are  liable  to  become  inflamed,  primarily  or  secondarily,  in 
strangles,  causing  great  pain  and  lameness. 

Inflammation  of  these  glands  may  be  detected  by  swelling, 
pain,  and  heat  in  front  and  below  the  point  of  the  shoulder,  in 
the  space  existing  between  the  sternum,  scapula,  and  humerus. 
The  limb  will  be  pushed  outwards  by  the  swelling,  there  will  be 
much  fever,  and  the  inflammation  and  suppuration  are  relieved 
only  by  the  opening  of  the  abscess  or  abscesses,  spontaneously 
or  surgically. 

The  pus  is  very  deep-seated,  and  it  is  necessary  to  open  the 
abscess  in  nearly  every  case  of  this  kind,  and  to  do  it  before 
there  are  any  signs  of  "pointing."  In  such  cases,  I  always 
explore  with  a  "  pin-director,"  and  invariably  find  out  where  the 
pus  is  situated.  I  then  make  a  free  opening  with  a  "  Syme's 
knife." 

ELBOW  LAMENESS 

Occurs  from  disease  of  the  joint,  sprain  of  the  lateral  ligaments, 
and  from  laceration  of  the  triceps  extensor  brachii  muscle. 

The  internal  lateral  ligament  may  be  sprained,  or  even 
ruptured,  by  the  animal's  fore  leg  slipping  outwards.  The 
triceps  muscle  is  often  injured  in  the  manner  already  described 
at  page  132,  and  by  the  animal's  fore  feet  slipping  forwards. 
These  accidents  commonly  happen  in  frosty  weather.  Cattle 
are  also  liable  to  these  injuries,  particularly  to  sprain  of  the 
internal  ligament. 

When  the  ligaments  are  sprained,  or  the  triceps  injured,  the 


ELBOW  LAMENESS.  2G1 

diagnosis  of  the  seat  of  lameness  is  easy,  for  there  will  be 
swelling,  pain,  and  heat,  in  addition  to  difficulty  in  mo^dng  the 
articulation.  When  the  internal  ligament  is  injured,  the  horse 
stands  with  his  foot  and  limb  thrown  outwards.  This  he  does 
to  prevent,  as  much  as  possible,  the  injured  parts  being  pressed 
upon  by  the  pectoral  muscles ;  and  when  the  triceps  is  the  seat 
of  the  injury,  the  fore  arm  is  flexed  upon  the  humerus ;  the 
action  of  the  flexor  brachii  being  now  unopposed,  the  knee 
is  elevated,  the  leg  flexed  from  the  knee  downwards,  the  toe 
of  the  foot  touching  the  ground,  and  the  limb  semi-pendulous. 
When  the  horse  is  made  to  move,  he  drops  considerably,  and 
seems  in  danger  of  falling  at  every  step  he  takes,  the  limb 
itself  almost  bending  double  when  any  weight  is  thrown  upon 
it.  This  excessive  dropping,  during  progression,  is  characteristic 
of  elbow-joint  lameness,  even  when  there  are  no  external  signs, 
such  as  heat,  swelling,  or  pain,  visible. 

Percivall  describes  a  case  of  elbow-joint  lameness  in  his  book 
on  lameness,  published  in  1849,  where  the  symptoms  were 
similar  to  those  of  laminitis.  I  have  never  witnessed  anything 
similar  to  what  is  described  by  Percivall,  namely,  an  animal 
putting  the  heel  first  to  the  ground  in  elbow-joint  lameness. 
Usually  the  limb  is  semi-flexed,  in  order  to  relax  the  articula- 
tion as  much  as  possible ;  the  toe,  during  motion,  first  coming 
to  the  ground. 

The  diagnostic  signs  of  elbow-joint  lameness  are,  first,  the 
semi-flexed  position  of  the  limb  whilst  the  horse  is  standing 
still ;  and  the  excessive  dropping  of  the  head  and  anterior  parts 
of  the  body  during  action. 

Professor  Dick  used  to  say  that  the  capsular  ligament, 
distended  with  synovia,  could  be  felt  through  the  skin  and 
subcutaneous  structures.  I  have,  however,  not  been  able  to 
confirm  this.  Photo -lithograph,  Plate  III.,  Pig.  2,  is  a  good 
illustration  of  elbow-joint  lameness. 

A  small  wound  upon  or  near  to  the  olecranon  gives  rise  to 
very  peculiar  symptoms.  The  wound  itself  may  be  so  small 
as  to  escape  detection  without  a  very  careful  examination. 
It  may  be  situated  upon  the  very  point  of  the  olecranon,  or 
upon  its  side,  or  even  in  the  space  between  the  thoracic  wall 
and  elbow.  The  wound  is  inflicted  commonly  whilst  hunting ; 
the  rider,  not  knowing  that  it  has  been  received,  rides  his  horse, 


262  PARTICULAR  LAMENESSES. 

and  as  a  result  of  motion,  air  is,  as  it  were,  purrped  into  the  sub- 
cutaneous areolar  tissue,  inflating  it,  first  in  the  neighbourhood 
of  the  wound,  and  then,  if  the  movements  be  continued,  over 
the  greater  part  of  the  animal's  body.  I  have  seen  the  head 
swollen  to  a  tremendous  extent,  the  eyes  closed  by  the  swollen 
lids,  the  neck,  shoulders,  dorsal  and  posterior  regions  so  blown 
up,  that  the  classification  of  the  patient  in  the  animal  kingdom 
became  a  matter  of  some  dififi.culty.  Such  a  condition  need 
occasion  but  little  alarm ;  all  that  will  be  requisite  is  to  find 
out  the  wound,  clean  it  well  with  warm  water,  plug  it  up  with 
tow  dipped  in  collodion,  and  keep  the  animal  still.  In  a  short 
time  the  air  will  be  absorbed,  and  the  swelling  dissipated.  If 
the  nostrils  are  so  greatly  swollen  as  to  interfere  with  the 
respiratory  functions,  endangering  the  animal's  life,  it  will  be 
necessary  to  puncture  the  skin  surrounding  them,  and  press  out 
the  contained  air ;  but  if  this  is  not  the  case,  there  is  no  neces- 
sity for  making  any  punctures. 


SPRAIN  OF  THE  RADIAL  OR  SUPERIOR  CARPAL  LIGAMENT. 

This  ligament,  sometimes  described  as  a  broad  band  of  fibrous 
tissue,  springs  from  the  posterior  surface  of  the  radius,  and 
becomes  inserted  into  the  flexor  perforatus  above  the  knee, 
and  is  also  continuous  with  the  perforans  muscle  and  ante- 
brachial fascia.  It  will  be  noticed,  upon  dissecting  the  fore 
extremity,  that  the  flexor  muscles  of  the  radial  region  are 
intermixed  with  a  large  quantity  of  white  fibrous  tissue — 
in  fact,  they  are  semi-tendinous  in  their  structure ;  and  that, 
both  above  and  below  the  knee,  any  undue  extension  of  them 
is  checked  by  ligamentous  bands,  which  arise  from  the  radius 
and  metacarpus  magnus,  and  become  continuous  with  their 
tendons  of  insertion. 

The  peculiarity  of  construction  here  noticed  enables  the  horse 
to  sleep  while  standing.  The  feet  are  made  fixed  points  by  being 
implanted  firmly  on  the  ground,  and  these  muscles  act  as  exten- 
sors of  the  shoulder,  preventing  the  animal  from  falling  by 
keeping  the  limbs  in  a  state  of  rigidity.  Had  they  been  com- 
posed wholly  of  muscular  tissue,  this  long-continued  action 
would  have  been  an  impossibility ;  but  containing  as  they  do  a 
large  amount  of  tendinous  structure  which  is  beyond  the  influ- 


SPRAIN  OF  RADIAL  LIGAMENT.  2G3 

ence  of  the  nervous  system,  and  hence  beyond  the  possibility 
of  fatigue,  the  mere  implanting  of  the  feet  upon  the  ground, 
by  causing  the  muscles  to  be  stretched,  produces  a  state  of 
rigidity  and  firmness  in  the  limbs  that  enables  the  animal  to 
stand  and  sleep  for  hours  together  without  danger  of  falling. 
The  muscles  are  strengthened  and  assisted  by  the  ligament- 
ous bands:  from  this  circumstance,  and  from  their  acting  as 
checks  to  over-extension,  they  are  liable  to  sprain  or  even 
rupture. 

Sprain  of  the  radial  ligament  is  manifested  by  lameness,  a 
difficulty  in  the  act  of  flexing  the  knee,  with  swelling,  heat, 
and  tenderness  immediately  above  the  knee,  posterior  to  the 
radius.  The  swelling  arises  from  exudation  of  lymph  into  the 
substance  of  and  around  the  ligament,  and  from  distension  of 
the  synovial  bursa,  through  which  the  tendons  pass,  behind  the 
knee.  In  some  cases,  both  perforatus  and  perforans  are  also 
involved  in  the  injury :  in  such  the  lameness,  pain,  and 
swelling  are  excessive,  and  flexion  exceedingly  difficult,  arising 
from  the  swollen  tendons  being  too  thick  to  play  through 
their  thecae,— just  as  a  rope  too  thick  for  a  pulley  retards 
motion. 

The  distension  of  this  bursa  appears  as  a  tense  but  fluctua- 
ting swelling  at  the  back,  and  slightly  above-  the  knee,  and  is 
sometimes  called  thorough-pin  of  the  knee. 

The  tendons  of  the  various  muscles  concerned  in  the  flexion 
and  extension  of  the  knee,  pastern,  and  foot,  passing  through 
thecse  upon  the  surfaces  of  the  carpus,  are  liable  to  injury, 
with  distension  of  their  various  synovial  sheaths  from  hyper- 
secretion of  synovia.  We  have  thus  the  theca  of  the  flexor 
metacarpi  externus  made  visible  on  the  outer  surface  of  the  os 
trapezium ;  the  sheath  of  the  flexor  metacarpi  internus  on  the 
inner  side  of  the  knee  ;  that  of  the  extensor  metacarpi  magnus 
in  front  of  the  knee  as  a  swelling  on  either  side  of  the  tendon ; 
and  those  of  the  other  extensors  upon  the  outer  surface  of  the 
carpal  articulations. 

These  enlargements,  when  arising  from  injury,  and  conse- 
quent thickening  of  the  tendons  themselves,  or  inflammation  of 
the  synovial  membrane,  cause  lameness ;  whilst  at  other  times 
they  are  mere  bursal  distensions  giving  rise  to  no  inconveni- 
ence. 


264  PARTICULAR  LAMENESSES. 

In  the  neighbourhood  of  copper  and  iron  smelting  works, 
bursal  enlargements  are  due  to  the  impregnation  of  the  animal 
system  with  mineral  poisonous  materials.  The  poison,  finding 
ingress  by  means  of  the  atmosphere  into  the  lungs  and  circula- 
tion, becomes  deposited  in  and  around  the  articulations,  more 
especially  of  the  knees,  and  finally  produces  anchylosis. 

All  cases  where  the  tendons  are  thickened  must  be  looked 
upon  as  unsound,  since  they  are  tied  down  by  the  enveloping 
thecse  and  annular  ligaments,  through  which  they  play;  and 
any  thickening  of  their  substance  must  destroy  that  facility  of 
motion  which  is  so  essential  to  soundness  of  action. 

The  bursa  of  the  extensor  metacarpi  magnus  sometimes  be- 
comes greatly  distended — constituting  what  is  termed  "  capped 
knee," — from  blows  or  the  entrance  of  thorns  whilst  hunting 
and  jumping  over  thorn  fences.  These  thorns  may  remain  in 
for  years  without  causing  any  apparent  inconvenience  to  the 
animal  beyond  some  swelling. 

When  capped  knee  is  first  observed  it  is  generally  accom- 
panied by  some  stiffness  and  pain,  showing  that  more  or  less 
inflammation  is  present.  These  symptoms  should  be  combated 
by  purgatives,  fomentations,  and  quietude.  After  a  time  all 
signs  of  inflammation  pass  away,  leaving  a  fluctuating  swelling. 
This  swelling  may  either  be  punctured  at  once,  or  its  reduction 
attempted  by  the  application  of  blisters.  Of  course,  if  a  thorn 
can  be  detected  it  must  be  at  once  removed.  Blisters,  when 
sufficiently  strong,  often  cause  the  reduction  of  these  swellings 
by  producing  an  exudation  of  lymph  into  the  distended  sac, 
converting  the  soft,  fluctuating  swelling  into  a  hardish,  indurated 
mass,  which  is  gradually  removed  by  absorption.  But  if  blisters 
— and  I  prefer  the  cantharidine  one  to  any  other,  with  mode- 
rately firm  pressure  after  the  soreness  of  the  blister  has  passed 
away — have  no  effect  in  reducing  the  swelling,  the  practitioner 
need  not  hesitate  to  puncture  and  allow  the  contained  fluid  to 
escape.  The  puncture  should  be  made  at  the  lowest  margin  of 
the  swelling,  and  upon  its  inner  side,  by  a  transverse  incision, 
in  order  to  blemish  as  little  as  possible.  After  the  puncture  is 
made  and  the  fluid  pressed  out,  the  walls  of  the  sac  must  be 
kept  in  apposition  by  means  of  a  flannel  bandage,  rolled  round 
the  knee  from  above  downwards,  until  they  become  united  by 
the  adhesive  inflammation.     The  bandage  should  not  be  dis- 


SPRAIN  OF  RADIAL  LIGAMENT.  265 

turbed  for  five  or  six  days  if  no  inconvenience  is  caused  to  the 
patient ;  but  if  any  signs  of  pain  are  manifested,  it  should  be 
removed  and  readjusted.  The  puncture  in  the  skin  must  be 
kept  open  (and  the  best  plan  to  do  this  is  to  insert  a  small  piece 
of  lint  or  tow  into  its  orifice,  allowing  it  to  remain  in  for  a  few 
hours),  in  order  to  allow  the  escape  of  any  fluid  which  might 
collect  in  the  sac.  The  bandage  is  placed  so  as  not  to  cover 
the  wound.  There  is  no  danger  to  be  apprehended  from  open- 
ing this  bursa.  I  have  done  it  repeatedly,  and  always  with 
success ;  and  sufficient  inflammation  is  excited  without  injecting 
iodine  or  any  other  irritant. 

Horned  cattle,  especially  milking  cows,  kept  in-doors,  are 
liable  to  have  enormously  enlarged  knees  from  distension  of 
these  bursse,  caused  by  bruising  while  lying  upon  hard  floors. 
They  may  be  opened  with  safety ;  and  the  best  plan  of  doing  so 
is  to  insert  a  seton  right  through  the  substance  of  the  swelling, 
and  allow  it  to  remain  in  for  three  or  four  weeks ;  the  knee  to 
to  be  protected  from  further  injury  by  a  good  thick  bed,  or  by  a 
thick  flannel  bandage  wrapped  round  it. 


CARPITIS,  OR  INFLAMMATION  OF  THE  KNEE. 

This  cause  of  lameness  was  investigated  and  laid  before  the 
profession  by  Mr.  Arthur  Cherry  (Veterinarian,  1845).  He 
gives  a  very  elaborate  account  of  it,  which  may  be  read  with 
advantage ;  but  in  his  over-zeal  for  what  seems  a  pet  theory,  he 
has  confounded  diseases  of  other  parts  of  the  limb  with  those  of 
the  knee.  For  example,  he  says  that  "  heat  in  the  foot  is  some- 
times felt  in  carpitis,"  and  that  what  the  old  farriers  called 
chest-founder  arose  from  this  inflammation  of  the  knee.  These 
statements  must  not  be  received  wi^^hout  great  caution,  as  they 
are  apt  to  mislead  the  young  practitioner.  Mr.  Cherry  says — 
"  Under  the  term  Carpitis  I  propose  to  describe  a  disease  of  the 
knee-joint  which,  in  its  commonly  existing  form,  has  never,  as 
far  as  I  am  aware,  been  specifically  described. 

"  The  knee-joint  itself  has  been  considered  to  be  exempt  from 
disease,  unless  from  the  infliction  of  direct  injury ;  indeed,  so  far 
did  the  late  Professor  Coleman  carry  his  opinion  on  this  subject, 
that  he  used  to  assert,  in  the  most  positive  manner,  that  the 
knee  was  never  the  seat  of  lameness. 


2QQ  PAETICULAR  LAMENESSES. 

Professor  Dick,  as  far  as  I  can  remember,  did  not  mention  the' 
existence  of  this  form  of  lameness ;  and  on  referring  to  my  notes 
of  his  lectures,  I  can  find  nothing  in  them  to  lead  me  to  think 
that  he  did  so,  although  the  Museum  contains  many  specimens 
of  the  disease. 

"The  gait  in  chronic  carpitis,"  says  Mr.  Cherry,  "affecting 
both  knee-joints,  gives  to  a  rider  the  sensation  of  the  chest 
being  displaced  from  its  right  position — a  sinking  or '  foundering,' 
and  which  feels  as  if  it  would  increase  at  every  step  of  the  horse. 
When  attention  is  drawn  to  this  peculiar  gait,  it  is  easy  to  be 
distinguished  from  the  short  cat-like  step  in  navicular  arthritis, 
which  gives  to  a  rider  a  sensation  of  the  chest  being  raised  up, 
or  an  attempt  at  doing  so ;  further,  the  feet  in  navicular  arthritis 
are  brought  to  the  ground  with  the  toe  first,  and  in  consequence 
the  step  is  short  and  stilty,  from  the  weight  being  as  much  as 
possible  thrown  on  the  column  of  bones,  to  relieve  the  affected 
tendon,  or  surface  over  which  it  plays ;  and  from  the  same  cause 
there  is  great  inclination  to  canter,  a  pace  which,  when  slow, 
brings  into  play  but  slightly  the  flexor  tendons  or  navicular 
joint.  In  carpitis,  on  the  contrary,  these  symptoms  are  reversed, 
from  the  cause  of  lameness  being  seated  on,  or  amongst,  the 
carpal  bones.  The  effort  is  not  now  to  throw  the  weight  on  the 
bony  column,  but  on  the  tendons  and  ligaments,  and  by  this 
means  to  avoid  concussion ;  hence  the  limb  is  carried  forward  as 
nearly  straight  as  possible ;  and  still  further  to  effect  this  object, 
it  is  thrown  with  a  circumductive  motion  outwards,  and  brought 
to  the  ground  with  the  heels  first,  as  is  shown  by  the  wearing 
away  of  the  points  of  the  heels  of  the  shoe.  This  mode  of  pro- 
gression produces  a  long  step,  and  at  the  same  time  the  fore 
quarters  are  dropped  or  lowered,  which  has  been,  I  doubt 
not,  the  origin  of  the  term  'chest-founder.'  There  is  also  a 
disinclination  to  canter;  and  if  this  pace  is  attempted,  it  gives 
increased  pain,  and  a  rocking  motion  exceedingly  unpleasant 
to  the  rider. 

"  The  diagnostic  characters  of  the  disease  affecting  one  leg  only 
are  the  same  as  exist  in  both,  but  from  the  contrast  which  is 
afforded  by  the  sound  limb,  these  are  much  more  recognisable 
than  when  both  are  affected ;  to  these,  however,  one  other  char- 
acteristic must  be  added — the  step  of  the  lame  leg  bein^  rather 
lunger  than  that  of  the  sound  limb." 


CARPITIS.  267 

The  characters  are  very  much  akin  to  those  of  shoulder  lame- 
ness, from  which,  however,  it  may  be  readily  distinguished — • 
first,  by  the  circumductive  manner  in  which  the  leg  is  thrown 
forwards,  and  the  straight  knee;  secondly,  by  the  absence  of  the 
dragging  of  the  whole  limb ;  thirdly,  by  the  stepping  on  the 
heels,  and  the  greater  firmness  on  standing  ;  but  one  of  the  best 
guides  perhaps  in  diagnosis  is  the  expression  of  pain  when  the 
affected  joint  is  forcibly  flexed  or  extended,  and  noting  which 
joint  is  attempted  to  be  least  brought  into  use  during  action. 

Mr.  Cherry  says — "  I  am  disposed  to  a  belief  that  there  is  in 
some  horses  a  hereditary  idiosyncrasy  to  this  disease ;  be  this 
as  it  may,  half-bred  are  much  more  prone  to  it  than  thorough- 
bred horses." 

The  inflammation  and  its  consequences  may  be  confined  to 
one  of  the  articulations  of  the  carpus,  more  particularly  to  that 
between  the  trapezoid  and  inner  small  metacarpal ;  or  the  dis- 
ease may  involve  several,  or  all  of  the  carpal  articulations. 

The  morbid  condition  of  the  joint  may  consist  of  simple 
inflammation,  terminating,  by  proper  treatment,  in  restoration, 
or  inflammation  associated  with  ulceration  of  the  articular  car- 
tilage, caries  of  the  bones,  and  a  deposition  of  osseous  matter 
external  to  and  around  the  diseased  portion,  constituting  anchy- 
losis.— (See  Photo-lithograph,  Plate  III.,  Fig.  3). 

The  inflammation  being  deep-seated  in  the  bones,  or  synovial 
membranes,  is  not  accompanied  by  much  external  heat;  and 
the  articulations  of  the  knee,  with  their  synovial  membranes 
and  capsular  ligaments,  being  small  and  incapable  of  contain- 
ing much  synovia,  account  for  the  absence  of  external  swelling 
until  there  is  a  deposition  of  osseous  matter. 

In  many  young  horses,  especially  when  they  are  first  put  to 
work,  we  meet  with  an  occult  lameness  which  is  most  puzzling. 
There  is  no  heat,  swelling,  nor  pain  upon  pressure  in  any  part 
of  the  limb  or  foot.  The  animal  is  moderately  sound  when  it 
first  comes  out  of  the  stable  in  the  morning,  but  shows  signs  of 
increased  lameness  after  being  at  work  for  a  short  time.  In  such 
cases,  the  practitioner  cannot  be  far  wrong  in  pronouncing  the 
lameness  to  be  in  the  bones  of,  or  adjacent  to,  the  knee-joint. 

The  osseous  deposits  arising  from  carpitis,  when  not  caused 
by  the  fumes  of  metals,  are  generally  situated  on  the  inner  side 
of  the  joint.      This  is  due  to  the  bones  being  here  more  under 


268  PARTICULAR  LAMENESSES. 

the  centre  of  gravity,  receiving  a  larger  share  of  the  weight,  and 
bearing  more  concussion  than  those  on  the  outer  side;  therefore 
the  head  of  the  inner  metacarpal,  the  trapezoid,  and  os  magnum 
in  the  lower,  and  scaphoid  and  lunar  in  the  upper  row,  are  most 
commonly  diseased;  but  it  is  very  rare  indeed  to  find  the  dis- 
ease extending  to  the  bones  of  the  upper  row. 

Treatment. — Eemoval  of  the  shoes;  loose  box  in  preference 
to  the  field  or  stall;  with  other  remedies  appropriate  to  lame- 
ness, to  be  described  hereafter. 


CHAPTER  XIV. 

PATiTicuLAR  LAMENESSES — Continued. 

SPEEDY-CUT — BROKEN  KNEES — SPRAIN  OF  FLEXOR  TENDONS — SPRAINS 

OF    SUSPENSORY    LIGAMENT — SPRAIN    OF    FETLOCK-JOINT SESA- 

MOIDITIS — RIN  G-BONES. 

"  Speedy-Cut  "  is  the  name  of  an  injury  to  the  region  of  the 
carpus,  which  often  causes  lameness.  This  injury  is  inflicted 
by  the  horse  striking  his  leg  with  the  opposite  foot.  Sometimes 
the  bruise  is  above  the  knee,  upon  the  skin  covering  the  promi- 
nent process  upon  the  internal  surface  of  the  radius,  which  gives 
attachment  to  the  lateral  ligament  of  the  joint.  It  is  only  high- 
stepping  horses  that  are  liable  to  inflict  this  injury  in  the  trot, 
but  in  the  gallop  almost  any  horse  may  do  it. 

When  a  horse  strikes  himself,  as  in  speedy-cut,  he  is  liable  to 
fall  from  the  violence  of  the  pain,  thus  endangering  the  life  of 
the  rider,  and  breaking  his  own  knees. 

In  the  examination  of  horses  as  to  soundness,  care  must  be 
taken  to  detect  any  marks  of  former  bruises  upon  the  inner 
side  of  the  knee  arising  from  this  cause.  The  marks  may  be 
on  the  lower  extremity  of  the  radius,  or  upon  any  prominent 
part  of  the  inner  surface  of  the  knee  or  head  of  the  metacarpal 
bone.  Wherever  situated,  I  am  of  opinion  that  they  should  be 
considered  as  causes  of  unsoundness,  since  they  indicate  a  fault, 
which  at  any  time  may  interfere  with  the  usefulness  of  the 
animal. 

The  symptoms  of  speedy-cut  are — inflammation  and  swelling 
of  the  skin,  collection  of  fluid  in  the  subcutaneous  areolar  tissue, 
constituting  a  serous  abscess,  or  the  formation  of  pus  in  the 
part,  with  lameness,  accompanied  occasionally  by  a  good  deal  of 
fever. 


270  PARTICULAR  LAMENESSES. 

Prevention  is  better  than  cure,  and  many  horses  will  do  well 
enough  if  properly  shod  with  either  the  three-quarter  or  Charlier 
shoes.  The  foot  must  be  kept  narrow  on  the  inner  side,  and 
the  shoes  removed  about  every  three  w^eeks,  otherwise,  by  growth 
of  the  foot,  the  animal  is  apt  to  strike.  I  have  known  many 
cases  of  this  kind  where  it  was  essential  to  remove  and  readjust 
the  shoes  at  the  end  of  three  weeks,  otherwise,  mischief  was  sure 
to  follow.  If  due  attention  to  shoeing  does  not  prevent  it,  a 
boot  must  be  made,  extending  as  high  as  the  knee,  wdth  a  rim 
on  its  upper  extremity  to  keep  off,  as  it  were,  the  interference  of 
the  other  foot.  I  do  not  think  that  narrow-chested  are  more 
liable  to  "  speedy-cut "  than  wide-chested  animals ;  round  high 
action  being  generally  the  cause.  , 

The  treatment  of  the  active  symptoms  arising  from  the  injury 
consists  in  fomentations  to  the  part,  purgatives,  the  opening  of 
the  abscesses,  whether  serous  or  purulent,  and  the  removal  of 
any  thickening  which  may  remain,  after  the  active  symptoms 
have  passed  away,  by  the  application  of  iodine  or  biniodide  of 
mercury. 

BROKEN  KNEES. 

A  w^ound  upon  the  anterior  part  of  the  knee,  although  of  itself 
a  mere  scratch,  is  of  such  importance  that  it  lowers  the  value  of 
the  animal  to  a  very  great  extent.  Many  are  the  excuses  for 
a  broken  knee.  It  is  very  true  that  many  knees  are  broken 
through  carelessness  on  the  part  of  the  rider  or  driver ;  and  in 
judging  such  the  veterinarian  must  draw  a  distinction  between 
a  good  and  a  bad  goer,  between  a  w^ell-made  horse  and  the  re- 
verse. Marks  of  speedy-cut  and  cutting  or  brushing  must  also 
be  looked  for,  as  the  infliction  of  these  is  apt  to  cause  the 
animal  to  fall. 

If  a  horse,  well  made,  with  ver}^  fine  action,  has  broken  knees, 
the  cause  may  be  purely  accidental — bad  shoeing,  carelessness, 
or  to  the  animal  being  subject  to  fits  of  vertigo. 

Broken  knees  are  of  five  kinds: — 'ist.  "VVlien  the  skin  is 
bruised,  but  not  cut ;  2d.  When  the  skin  is  cut ;  3d.  When  the 
skin  is  divided,  more  or  less  lacerated,  the  tendon  of  the  extensor 
magnus  exposed,  and  its  bursa  opened ;  Ath.  Wlien  the  wound 
penetrates  through  the  tendon,  exposing  the  carpal  articulations ; 
dth.  The  last  form,  with  fracture  of  one  or  more  bones. 


BROKEN  KNEES.  271 

1st.  \^^len  the  skin  is  simply  bruised,  the  hair  being,  as  it 
were,  shaved  off,  with  a  little  oozing  of  blood.  This  need 
cause  no  uneasiness  as  to  after-blemish,  if  properly  treated ;  but 
if  treated  in  the  common  way — by  hot  fomentations,  flannel 
bandages,  and  stimulating  ointments  or  liniments — a  blemish  is 
the  sure  result. 

The  proper  method  of  treatment  is  as  follows : — 1st.  Tie  up 
the  animal's  head,  so  that  it  cannot  lie  down.  This  I  hold  to 
be  important,  for  the  skin  may  be  so  injured  that  but  little 
additional  pressure  is  required  to  cause  it  to  slough,  and  slough- 
ing, however  trifling,  will  leave  a  blemish.  In  addition  to 
tying  the  head,  all  that  is  required  is  to  sponge  the  knee 
lightly  with  some  cooling  application,  such  as  the  v/hite  lotion, 
repeatedly,  for  two  or  three  days,  or  until  the  inflammation  has 
subsided.  If  much  swelling  should  arise,  a  purgative  should 
be  given. 

2d.  When  the  skin  is  cut.  The  edges  should  be  brought 
together  as  well  as  possible,  and  so  kept  by  plaster,  or  styptic 
colloid,  or  shellac  paste  dipped  in  lint  or  tow.  A  wound  on 
the  knee  must  never  be  pinned  or  stitched,  for  flexion  of  the 
part  will  most  assuredly  tear  out  the  pin  or  suture,  with  a 
piece  of  skin  as  well,  and  thus  increase  the  blemish.  In  addi- 
tion to  the  colloid  or  plaster,  a  light  calico  bandage  may  be 
applied,  the  horse's  head  tied  up,  and  the  dressing  not  inter- 
fered with  for  four  or  five  days,  if  the  case  progresses  favour- 
ably. But  if  the  leg  should  swell,  or  show  signs  of  pain  and 
inflammation,  the  bandages  must  be  removed,  and  the  wounds 
examined ;  if  found  to  be  suppurating,  they  are  to  be  lightly 
washed,  and  afterwards  dressed  with  mild  astringents,  or  very 
dilute  carbolic  acid — one  to  200  parts  of  water  is  strong  enough 
— or  the  white  lotion,  with  a  small  quantity  of  the  carbolic  acid, 
will  do  very  well. 

It  must  be  understood  that  before  the  edges  of  the  wound 
are  brought  together,  all  foreign  bodies,  such  as  dirt,  hay -seeds, 
&c.,  are  to  be  removed.  Very  often  a  small  piece  of  dead  tissue 
will  be  seen,  presenting  a  deadened  white  appearance  in  the 
wound.  This  should  be  removed  by  the  curved  scissors,  other- 
wise it  will  act  as  a  foreign  body. 

Sd.  When  the  skin  is  divided,  more  or  less  lacerated,  ex- 
posing the  magnus  tendon,  it  does  not  necessarily  foUow  that, 


272  PAKTICULAR  LAMENESSES. 

althougli  tliere  is  a  discharge  of  synovia  from  the  wound,  there 
is  true  open  joint,  for  the  bursa  of  the  extensor  metacarpi 
magnus  is  separated  from  those  of  the  articulations. 

Cases  of  this  kind  look  very  formidable,  the  resulting  in- 
flammation being  sometimes  great,  the  swelling  very  consider- 
able, extending  as  hifjh  as  the  elbow-joint,  and  as  low  as  the 
foot ;  the  whole  limb  being  infiltrated  with  effusion  and  exuda- 
tion. The  carpal-joint  becomes  greatly  enlarged  by  a  fibrinous 
deposit,  which  surrounds  it,  and  the  synovial  discharge  very 
profuse.  Generally,  with  proper  treatment,  such  cases  recover, 
if  the  tendon  be  not  crushed. 

Ath.  If  the  tendon  has  been  crushed,  although  neither  lace- 
rated nor  divided  in  any  way,  it  may  slough  in  the  course  of 
four  or  five  days,  its  vitality  having  been  destroyed.  This 
sloughing  of  the  tendon  is  attended  with  severe  symptoms,  and 
is  a  source  of  great  danger  to  the  animal's  life.  The  sympathetic 
fever  becomes  very  high  ;  the  respirations  and  pulse  quickened ; 
the  bowels  constipated ;  the  urinary  and  other  secretions  arrested ; 
both  the  wound  and  tendon  assume  a  dusky  livid  or  leaden 
hue ;  the  discharge  becomes  foetid,  sanious,  mixed  with  blood, 
and  the  lameness  excessive.  When  the  slough  is  removed,  the 
carpal  articulations  are  exposed  to  view;  the  bones  are  in- 
flamed, and  of  a  red  hue.  The  power  of  extension  is  now  lost 
by  the  separation  of  the  tendon  from  its  attachment,  and  the 
limb  is  persistently  flexed.  If  an  attempt  be  made  to  extend 
it  forcibly,  great  pain  is  inflicted. 

The  treatment  of  such  cases,  whether  the  division  of  the  ten- 
don be  immediate  or  not,  is  a  matter  of  anxiety  to  the  veterinary 
surgeon,  and,  except  when  the  patient  is  a  valuable  stud  animal, 
it  is  better  to  destroy  it,  for  even  if  a  cure  is  effected,  the 
articulation  will  be  anchylosed  ;  and  a  horse  with  an  anchylosed 
knee  is  of  little  use.  But  if  an  attempt  is  to  be  made  to  effect 
a  cure,  the  limb  must  be  fixed  in  the  straight  position  by  means 
of  the  tin  splint  recommended  for  fractures,  placed  behind  the 
knee,  and  fastened  by  proper  straps  and  bandages,  leaving  the 
wound  uncovered. 

In  the  treatment  of  open  bursa,  or  even  when  the  skin  only  is 
divided,  it  is  always  advisable  to  apply  the  splint  for  the  purpose 
of  preventing  motion,  and  to  prevent  a  horse  from  accidentally 
striking  the  wounded  knee   against  the  manger,  to  turn  him 


BROKEN  KNEES.  273 

round  in  the  stable,  and  supply  him  with  food  by  means  of  a 
bag  suspended  from  the  stall-posts ;  the  slings  in  the  graver 
lesions  playing  a  most  essential  part. 

In  some  rare  instances  the  wound  in  the  skin  and  tendon  is 
situated  at  the  inferior  part  of  the  knee,  over  the  articulations  of 
the  lower  row  of  carpal  bones  and  the  metacarpals.  A  wound 
in  this  part,  although  penetrating  deeply  and  opening  into  the 
joint,  is  not  nearly  so  dangerous  as  one  over  the  articulation 
between  the  two  rows :  for  there  is  but  little  motion,  the  suc- 
ceeding inflammation  is  not  nearly  so  great,  nor  the  supervening 
anchylosis  so  important. 

bth.  When  the  accident  has  been  sufficiently  severe  to  fracture 
one  or  more  bones  of  the  knee,  the  animal  should  be  destroyed. 

The  causes  of  lameness  now  to  be  described,  extending  to 
the  foot,  are  mostly  common  to  both  anterior  and  posterior 
extremities.  When  they  are  not  common  to  both,  special 
reference  will  be  made  to  them.  They  may  be  enumerated  as 
follows : — 

1.  Sprain  of  the  flexor  tendons. 

2.  „       of  suspensory  ligament. 

3.  Inflammation  of  the  sesamoid  bursa. 

4.  „  of  the  fetlock-joint. 

5.  Eupture  of  lateral  ligaments  of  fetlock-joint. 

6.  Knuckling  over. 

7.  Sprain  of  inferior  suspensory  ligaments. 

8.  Wind-galls. 

9.  Eing-bones. 

10.  Sprained  pasterns. 


SPRAIN  OF  THE  FLEXOR  TENDONS. 

The  so-called  sprain  of  the  back  sinews  is  not  primarily  in 
reality  a  lesion  of  the  flexor  tendons  proper,  nor  of  their  thecae, 
but  consists  of  a  diseased  condition,  arising  from  over-extension 
of  the  metacarpal  or  metatarsal  check  ligaments,  situated  below 
the  knee  and  hock,  performing  the  same  functions  as  the  radial 
ligament  which  has  been  already  described. 

These  ligaments  arise  from  below  the  upper  extremities  of  the 


274  PARTICULAR  LAMENESSES. 

metacarpal  and  metatarsal  bones,  and  run  down  the  legs,  lodged 
in  the  fossae  upon  their  posterior  aspect,  bounded  on  either  side 
by  the  small  canon  bones.  They  are  external  and  posterior  to 
the  suspensory  ligament,  become  attached  to  the  great  perforans 
tendons  half  way  down  the  leg,  and  are  there  placed  to  prevent 
over-extension  of  the  tendons. 

Cart-horses  are  much  more  liable  to  this  lameness  than  any 
other  breed,  in  consequence  of  the  great  labour  they  perform  in 
drawing  heavy  loads.  This  can  easily  be  understood  by  watch- 
ing a  horse  start  a  heavy  weight — how  he  digs  his  toes  into  the 
ground,  making  his  feet  fixed  points,  upon  which  the  muscles, 
the  flexors  particularly,  are  made  to  act.  The  muscles  acting 
upon  two  fixed  points,  namely,  the  elbow  and  foot,  render  their 
tendons  tense  and  stretched.  Wlien  the  impetus  is  given  by 
which  the  load  is  started,  great  strain  is  thrown  upon  them  and 
their  check  ligaments,  by  which  they  are  extended ;  and  this 
extension,  acting  upon  inelastic  structures,  causes  some  of  the 
fibres  to  give  way — to  become  ruptured.  Eepeated  stretching 
produces  a  degenerated  condition  of  the  fibres,  by  which  they  are 
rendered  easily  lacerable. 

I  do  not  hold  tliat  it  is  always  necessary  to  have  actual 
rupture  of  the  fibres  to  constitute  a  sprain  of  a  tendon  or 
ligament.  Inflammation  can  occur  in  them,  non-vascular  as 
they  are,  without  this  lesion ;  and  extension,  although  not  pro- 
ducing rupture,  is  sufficient  to  produce  the  inflammatory  con- 
dition, more  especially  at  the  points  of  insertion  into  the 
bones. 

An  additional  cause  is  found  in  the  kind  of  shoe  that  cart- 
horses wear  in  some  parts  of  the  country,  shoes  with  heavy  toe- 
pieces  welded  across  them.  These  very  materially  increase  the 
resistance  to  the  action  of  the  flexors,  by  adding  to  the  obstacle 
to  be  overcome,  that  obstacle  being  the  foot  placed  on  the 
ground  with  the  weight  of  the  animal  upon  it.  The  foot  is  ele- 
vated upwards  and  backwards,  the  last  part  to  leave  the  ground 
being  the  toe ;  and  as  it  does  so  it  is  made  to  describe  the 
segment  of  a  circle :  we  tlierefore  find  that  the  toe  of  the  shoe 
is  rounded  off  as  it  wears.  It  will  easily  be  understood  how 
any  additional  resistance  to  this  last  act  in  its  elevation  becomes 
a  source  of  disease  in  the  structures  which  perform  it.  No  one 
can  deny  that  toe-pieces  enable  the  horse  to  have  a  stronger 


SPRAIN  OF  FLEXOR  TENDONS.  275 

hold  on  the  ground,  and  thus  prove  an  advantage  when  very- 
heavy  loads  are  to  be  moved,  more  especially  in  hilly  districts, 
but  this  very  advantage  of  grip  becomes  a  cause  of  lameness, 
from  the  fact  that  it  has  to  be  overcome  by  the  active  organs  of 
locomotion. 

When  a  ligament  or  tendon  is  inflamed,  an  exudation  takes 
place  both  within  and  external  to  its  substance.  That  within 
the  structure,  or  the  inter-fibrous  exudate,  separates  the  fibres 
from  each  other,  causes  them  to  diverge  from  the  straight  line, 
and  thus  the  ligament  or  tendon  becomes  shortened ;  hence  we 
find  that  in  this  strain  a  horse  is  unable  to  bring  the  heel  of 
the  foot  to  the  ground.  This  shortening,  particularly  during 
the  early  stages,  is  increased  by  the  muscles  being  kept  in  a 
contracted  condition,  to  relieve  the  inflamed  part  from  tension ; 
but  after  a  time  descent  of  the  heel  is  rendered  an  impossibility 
by  adhesions  and  actual  shortening  from  organic  change  in 
the  non-active  structures  (the  tendons  and  ligaments)  of  loco- 
motion. 

Symptoms. — There  will  be  heat  and  swelling  in  the  part; 
very  often,  during  the  earlier  stages,  the  ligament  can  be  felt 
swollen,  prominent,  and  bulging,  the  tendons  themselves  being 
quite  normal;  when  pressed  upon,  the  horse  evinces  pain ;  stands 
with  the  leg  upright,  and  moves  it  stiffly,  digging  his  toe  into 
the  ground.  When  in  the  hind  leg,  flexion  is  very  imperfectly 
performed ;  he  seems  to  throw  the  limb  behind  him  as  he  lifts 
it  from  the  ground,  and  the  fetlock  and  hock  are  not  flexed  as 
in  sound  action.  When  the  tendons  themselves  are  involved 
they  will  be  found  swollen  upwards  and  downwards  from  the 
seat  of  the  original  injury;  and  this  extension  of  the  swelling 
prevents  their  gliding  through  their  thecse,  particularly  the  thecee 
situated  in  the  carpal  or  tarsal  fossae. 

To  detect  veiy  slight  sprains,  especially  if  situated  in  a  hind 
leg,  it  will  often  be  necessary  to  compare  the  thickness  of  both 
legs  by  careful  manipulation,  as  the  swelling  can  only  be  de- 
tected in  that  way,  on  account  of  the  coarse  hair  and  thick  skin 
of  cart-horses'  legs.  In  the  better  bred  animal,  a  difference  in 
the  thickness  can  be  easily  seen  as  well  as  felt. 

The  special  treatment  required  for  this  lameness  is  the  appli- 
cation of  the  high-heeled  shoe,  in  order  to  throw  the  tendons 
into  a  state  of  relaxation,  and  a  long  period  of  rest.     In  chronic 


276  PARTICULAR  LAMENESSES. 

cases,  where  shortening  has  permanently  taken  place,  the  opera- 
tion of  tenotomy  must  be  performed. 

Many  horses  with  contraction  of  the  tendons  will  perform 
very  slow  w^ork  moderately  well  if  a  piece  of  iron  is  attached  to 
the  toe  of  the  shoe,  projecting  an  inch  or  two  in  front  of  it,  and 
slightly  turned  up  at  its  anterior  part.  This  acts  as  a  lever 
upon  the  toe,  forcing  the  heel  downwards,  and  prevents  "  knuck- 
ling over  "  on  the  front  of  the  fetlock- joint. 

Tenotomy,  or  division  of  the  tendons,  is  performed  as  follows : — 
The  animal  must  be  cast  with  the  lame  limb  lying  undermost, 
which  is  to  be  detached  from  the  hobble,  and  kept  in  a  semi-flexed 
position  by  a  cord  placed  round  the  fetlock.  The  operator  must 
feel  for  the  anterior  edge  of  the  tendon,  a  little  below  the  middle 
of  the  leg.  He  then  must  introduce  a  small  sharp-pointed  scalpel, 
flatwise,  through  the  skin  and  subcutaneous  tissue,  which  occu- 
pies the  space  between  the  tendons  and  suspensory  ligament, 
until  its  point  touches  the  skin  of  the  opposite  side  of  the  leg, 
keeping  close  to  the  tendon  to  avoid  dividing  the  artery.  The 
sharp-pointed  scalpel  is  now  withdrawn,  and  a  probe-pointed 
tenotomy  knife  introduced  in  the  same  manner,  until  the  probe 
point  can  be  felt  by  the  operator  under  the  skin  of  the  opposite 
side,  when  its  edge  must  be  turned  towards  the  tendon,  and  the 
limb  forcibly  extended  by  an  assistant.  This  extension  will 
cause  the  tendon  to  press  firmly  on  the  edge  of  the  knife,  the 
operator  at  the  same  time  cutting  slowly  towards  the  wound  in 
the  skin.  The  movements  of  the  knife  must  be  slow  and 
cautious  (or  the  skin  may  be  wounded),  until  both  perforans 
and  perforatus  are  cleanly  cut.  In  many  cases  it  is  found  that 
the  heel  cannot  be  brought  to  the  ground  owing  to  the  presence 
of  old  adhesions  about  the  fetlock  and  pastern  joints.  These 
adhesions  must  be  forcibly  broken  by  powerful  extension,  such 
as  by  the  operator  placing  his  knee  against  the  front  of  the  horse's 
leg,  and  forcibly  drawing  the  leg  and  foot  forward  until  the 
adhesions  give  way. 

In  performing  tenotomy,  a  small  wound  is  essential ;  for  if 
a  large  one  be  made,  a  fungous  growth  springs  up  from  it, 
which  is  difficult  to  remove,  and  which  sets  up  the  suppurative 
action,  causes  irritative  fever,  delays  the  healing  process,  and 
leaves  an  ugly  blemish. 

The  incision  through  the  skin  is  always  made  in  the  fore  leg 


SPRAIN  OF  FLEXOR  TENDONS.  277 

on  the  inner  side,  and  for  the  reason  that  the  operator  can 
Letter  avoid  dividing  the  artery.  In  the  hind  leg,  it  does  not 
matter  from  which  side  the  knife  is  introduced,  for  the  artery  is 
there,  unless  the  operation  be  very  low  down,  protected  by  the 
external  small  metatarsal  bone.  In  all  cases  the  skin  must  not 
be  wounded  on  the  side  opposite  to  that  by  which  the  scalpel  is 
introduced. 

The  after  treatment  is  very  simple,  if  the  operation  has  been 
properly  performed ;  the  wound  may  be  pinned,  the  leg  lightly 
bandaged,  and  occasionally  moistened  with  tepid  water;  the 
horse's  head  tied  to  the  rack  for  two  or  three  days ;  at  the  end 
of  which  time  the  wound  will  have  healed. 

As  a  rule,  I  have  all  the  shoes  removed  before  I  perform  an 
operation  of  this  kind,  and  the  feet  rasped  to  as  near  their 
natural  proportions  as  possible.  This  is  important,  as  the  lame 
foot  is  apt  to  be  allowed  to  grow  at  the  heel  to  an  enormous 
extent.  All  this  overgrowth  must  be  removed,  or  deformity  of 
the  lesf  will  arise  from  it. 

In  a  few  days  after  the  operation,  or  in  some  cases  immediately, 
if  no  adhesions  exist,  it  wiU  be  seen  that  the  horse  brings  the 
heel  of  the  foot  to  the  ground,  and  that  the  toe  is  turned  up 
when  he  is  made  to  move.  This  need  not  cause  any  apprehen- 
sion ;  indeed,  the  only  drawback  to  the  success  of  the  operation 
is  the  contraction  of  the  new  formation  uniting  the  divided  ends 
of  the  tendons,  and  the  re-assumption  of  the  form,  to  overcome 
which  the  operation  has  been  performed.  I  always  feel  sure  of 
a  successful  operation  if  the  animal  continues  to  walk  upon  the 
heel  for  some  weeks  afterwards,  and  I  never  apply  a  high-heeled 
shoe  to  such  a  case. 

The  operation,  although  promising  in  itself,  and  successful  in 
restoring  the  limb  to  its  natural  position,  very  frequently  proves 
a  source  of  disappointment,  from  the  fact  that  the  reparative 
material,  which  is  thrown  out  between  the  ends  of  the  divided 
tendons,  gradually  contracts,  whereby  the  tendons  are  made  as 
short  as  before  it  has  been  performed.  In  the  hind  leg  this 
contraction  is  the  usual  consequence,  and  the  tendency  to  it  has 
to  be  overcome  by  a  lever  at  the  toe  of  the  shoe.  This  often 
arrests,  but  seldom  finally  prevents  it.  In  the  fore  extremity 
the  operation  is  much  more  successful,  the  limb  maintaining  its 
natural  condition  for  years  afterwards. 


278  PARTICULAR  LAMENESSES. 

There  is  generally  an  amount  of  thickening  leil  in  the  leg ; 
but  since  this  does  not  prevent  the  free  use  of  the  limb,  it  need 
not  be  interfered  with,  as  it  gradually  becomes  absorbed,  and  in 
the  course  of  time  the  leg  will  look  very  respectable. 

A  horse  should  not  be  put  to  hard  work  for  at  least  six  months 
after  the  operation  has  been  performed  on  a  fore  leg;  if  on  a 
hind  leg  he  will  require  a  much  longer  period. 

SPRAIN  OF  THE  SUSPENSORY  LIGAMENT. 

The  superior  sesamoidean  or  suspensory  ligament  is  a  broad 
strong  band  of  white  fibrous  tissue,  arising  from  the  supra-pos- 
terior part  of  the  canon  bone,  lying  in  the  hollow,  bounded  on 
either  side  by  the  small  canon  bones ;  it  extends  downwards, 
bifurcating  above  the  fetlock,  becoming  attached  to  the  lateral 
parts  of  the  sesamoids,  thence  it  is  continued  downwards  and 
forwards  to  the  tendon  of  the  extensor  pedis  at  the  antero- 
inferior part  of  the  os  suffraginis,  where  its  divisions  become 
united,  and  are  generally  lost  in  the  substance  of  that  tendon ; 
but  in  the  young  subject  a  careful  dissection  generally  shows 
that  it  acjain  becomes  divided,  and  that  its  two  divisions  travel 
along  the  lateral  part  of  the  os  coronse,  terminating  there,  and 
on  either  side  of  the  pyramid  of  the  os  pedis. 

Much  difference  of  opinion  exists  amongst  veterinarians  as 
to  whether  this  ligament  is  elastic  or  not, — Percivall,  Dick,  and 
others  maintaining  that  it  is  so ;  whilst  the  late  Professor 
Barlow,  from  a  careful  investigation  into  its  structure,  argued  to 
the  contrary. 

I  am  quite  convinced  that  the  latter  view  is  the  correct  one, 
and  that  the  sesamoid  bones  do  not  descend  and  ascend  during 
action  in  the  manner  described  by  Percivall,  who  says — "  In 
proportion  as  the  pastern  is  upright  in  position,  less  weight  is 
imposed  upon  tlie  sesamoid  bones,  more  upon  the  pastern,  and 
vice  versa.  AVliat  pressure  or  weight  the  pastern  bone  receives 
descends  to  the  coronet,  and  then  to  the  os  pedis.  But  what 
becomes  of  the  weight  upon  the  sesamoids  ?  they  have  no  bones 
below  to  transmit  it  to.  They  are  in  a  somewhat  similar 
situation  to  the  splint  bones ;  they  call  upon  their  attaching 
bands  (their  ligaments)  to  support  them  under  their  load,  and 
their  ligaments  do  so  by  yielding,  they  being  elastic,  so  long 


SPRAIN  OF  SUSPENSORY  LIGAMENT.  279 

as  force  is  operating ;  and  the  instant  it  is  not,  they,  through 
their  elasticity,  again  recover  their  short  lengths,  and  so  raise 
the  sesamoid  bones  into  their  places.  This  descent  and  ascent 
of  the  sesamoids  is  not  to  be  compared  with  that  imperceptible 
and  disputed  motion  of  the  splint  bones ;  on  the  contrary,  it  is 
a  demonstrable  and  beautiful  descending  and  ascending  motion ; 
a  playing  up  and  down,  after  the  manner  of  a  spring  of  most 
elastic  and  exquisite  workmanship,  imparting  at  every  step  the 
horse  takes  its  anti-concussive  influence  to  every  part  of  his 
frame.  Watch  the  long  and  elastic  fetlocks  of  the  Arabian  or 
race-horse  as  he  is  cantering  upon  turf,  and  at  every  bound  he 
makes  will  the  tufts  of  hair  from  those  joints  be  seen  dipping 
upon  the  ground,  though,  while  the  animal  is  standing  still,  they 
may  be  some  inches  removed  from  the  surface;  nothing  can 
evince  more  beautifully  and  plainly  than  this  the  movements  of 
the  fetlocks. 

"  The  attaching  band  or  ligament  upon  which  the  sesamoids 
repose  in  their  descent,  and  depend  for  their  re-ascent,  is  the 
suspensory.  And  in  order  to  show  what  proportion  of  the 
superincumbent  weight  these  bones  sustain,  or  rather  how  in- 
sufficient the  pastern  is  without  their  aid  to  support  the  burden, 
we  have  only  to  cut  the  suspensory  ligament  through;  that 
done,  the  horse  is  in  real  truth  broken  down;  the  feet  slip 
forward  and  the  toes  turn  up,  while  the  fetlocks  bend  down 
upon  the  ground.  Not  so  after  division  of  the  flexor  tendons ; 
we  occasionally  sever  them  by  way  of  remedy  for  knuckling 
over,  and  all  that  results  in  the  enabling  or  forcing  the  animal 
to  set  his  heel  upon  the  ground.  Once  divide  the  suspensory 
ligament,  however,  and  no  power  left  is  able  to  sustain  the 
pasterns  erect.  The  suspensory  ligament  is  therefore  one  of 
the  main-springs  of  the  machine-  in  action;  one  of  the  chief 
of  those  beautiful  contrivances  which,  while  they  save  the  leg- 
bones  from  being  smashed  to  pieces  under  the  weight  and  shocks 
they  have  to  sustain  at  every  bound  and  leap  the  animal  makes, 
insures  his  rider  ease  and  safety  to  his  journey's  end." 

This  quotation  is  very  eloquent,  but  unfortunately  the  idea 
it  conveys  is  incorrect  in  every  particular.  In  the  first  place, 
the  sesamoids  do  not  sustain  any  part  of  the  weight  of  the 
animal's  body,  being  placed  external  to  the  bony  skeleton, 
having  no  bones  either  immediately  above  or  below,  being,  ia 


280  PARTICULAR  LAMENESSES. 

fact,  muscular  appendages^  like  the  patdloe  and  naviculares, 
by  which  leverage  power  is  given  to  the  muscles  whose  tendons 
are  inserted  into  or  play  over  them.  They  are  thus  entirely 
different  from  the  small  splint  bones,  which  bear  concussion, 
being  placed  beneath  other  weight-bearing  bones,  and  add  to  the 
bulk  of  the  lower  part  of  the  knee,  without  increasing  its 
weight  to  any  great  extent,  which  would  be  the  case  if  the  leg 
were  in  one  piece;  and  by  being  attached  by  inter-osseous 
ligaments,  not  elastic  ones,  as  Percivall  maintains,  deaden  and 
modify  concussion  much  more  effectually  than  if  the  union  w^ere 
entirely  bony. 

2d.  The  suspensory  ligament  is  not  to  any  extent  elastic,  and 
is  for  the  purpose  of  keeping  the  sesamoids  in  their  position 
to  prevent  their  descent  in  the  same  way  as  the  inferior  suspen- 
sory Kgament  prevents  their  ascent  during  the  movements  of 
the  tendons ;  and  also,  by  keeping  the  sesamoids  firmly  pressed 
against  the  fetlock-joint,  it  forms  a  brace  or  stay,  which  pre- 
vents over-extension  of  the  fetlock  and  elevation  of  the  toe,  to 
which  there  is  always  a  tendency  from  the  pressure  of  the 
animal's  weight. 

2>d.  The  sesamoids  do  not  descend  and  ascend,  as  described 
by  Percivall,  and  even  if  the  suspensory  ligament  were  elastic, 
this  movement  in  the  bones  would  be  an  impossibility,  since 
they  are  firmly  attached  to  the  tuberosities  on  the  lateral  aspects 
of  the  upper  part  of  the  body  of  the  os  suffraginis  by  the  in- 
ternal and  external  lateral  sesamoidean  ligaments,  and  to  each 
other  by  the  inter-osseous.  In  fact,  they  are  pulleys,  over 
which  the  tendons  play  like  ropes,  enabling  them  the  more 
easily  to  lift  the  feet  from  the  ground. 

How  is  it,  then,  that  the  fetlock  pad  comes  nearly  to  the 
ground  at  every  stride  of  the  race-horse  ?  It  is  because  the 
wdiole  limb  is  pressed  downwards  upon  the  fetlocks,  pastern, 
and  cotfin  bones,  which  are  placed  obliquely  under  the  animal's 
body ;  and  this  seeming  descent  of  the  sesamoids  is  simply  an 
increase  of  this  obliquity. 

Dissections,  and  observations  on  the  limb  of  the  living  animal, 
have  convinced  me  that  extension  at  the  fetlock-joint  is  very 
limited,  and  that  it  is  an  impossibility  to  increase  the  obliquity 
of  the  pastern,  even  by  very  gTeat  pressure  upon  the  fetlock- 
joint,  while  the  suspensory  ligament  is  uncut,  and  that  the  in- 


SPRAIN  OF  SUSPENSOEY  LIGAMENT.  281 

crease  of  obliquity  wliich  is  seen  during  rapid  action  is  due  to 
the  movements  of  the  os  coronse  on  the  pedal  bone,  the  articula- 
tion between  them  admitting  of  extension  to  a  much  greater 
degree  than  any  of  the  other  phalangeal  articulations.  If  it 
be  carefully  noted,  the  movement  between  the  os  suffraginis 
and  metacarpal  is  almost  confined  to  flexion ;  that  between  the 
suffraginis  and  coronse  very  limited  in  every  way ;  whilst  the 
formation  of  the  inferior  articular  extremity  of  the  os  coronse 
and  the  articular  surface  of  the  cofiin  bone  admit  of  both 
flexion  and  extension,  the  first  movement  being  more  limited 
than  the  latter.  To  prove  this  by  analogy,  let  the  experi- 
mentalist press  a  table  with  the  bulb  of  his  finger,  and  it  will 
be  seen  at  once  that  the  distal  is  much  more  capable  of  ex- 
tension than  the  rest  of  the  phalangeal  articulations.  The 
comparison  is  a  good  one,  as  the  articulations  of  the  human 
fingers  and  those  of  the  pastern  of  the  horse  are  very  much 
alike.  It  is  a  necessity  to  the  well-being  of  the  animal  that 
the  greatest  adaptability  to  extension  should  be  at  the  ex- 
tremity of  the  limb,  as  the  greatest  pressure  is  there ;  in  fact, 
the  pastern  is  a  lever,  extending  from  the  fetlock  to  the  foot, 
and  the  greater  the  length  it  has,  the  more  oblique  it  will  be. 

The  limb  not  only  descends  at  the  pastern  during  motion, 
but  it  also  ascends  at  the  shoulder,  where  the  body  is  suspended 
upon  it  by  the  seratus  magnus  and  other  muscles.  "We  have 
thus  a  spring  below  and  a  spring  above, — a  wonderful  and 
beautiful  provision  to  destroy  the  effects  of  concussion,  which 
would  be  fatal  to  the  animal  when  all  the  weight  of  his 
body  is  thrown  upon  the  fore  extremity  during  galloping  or 
jumping.  The  hind  extremity,  unlike  the  fore  one,  is  attached 
to  the  trunk  by  means  of  an  articulation — the  hip-joint — be- 
cause the  forces  that  produce  concussion  are  not  applied  to  it 
in  the  same  degree  as  to  the  fore  one ;  the  impulse  of  rapid 
pace  throwing  the  weight  from  the  hind  upon  the  fore  extremity; 
hence  it  is  that  one  spring,  namely,  the  inferior  one,  is 
sufiicient. 

The  suspensory  ligament  being  to  all  intents  and  purposes 
inelastic,  and  the  sesamoid  bones  firmly  bound  to  it,  to  the 
fetlock,  and  to  the  pastern,  assists  in  supporting  those  parts  of 
the  limb  which  are  below  it,  namely,  tlie  pastern  and  the  foot, 
by  forming  a  brace    or   stay,  exactly  in  the    same  way   as  a 


282  PARTICULAR  LAMENESSES. 

rope  fixed  in  like  manner  would  do.  Without  this  aid,  the 
power  of  the  flexor  muscles  would  be  quite  insufficient  for  the 
purpose,  and  without  the  suspensory  ligament  the  horse's  toes 
would  be  turned  up,  particularly  while  the  muscles  were  in- 
active ;  but  with  its  assistance  they  are  enabled  to  obtain  that 
repose  which  is  so  essential  to  the  well-being  of  all  muscular 
tissue. 

Nothing  proves  this  staying  or  bracing  function  of  the  sus- 
pensory ligament  and  sesamoids  so  much  as  rupture  of  the 
ligament  or  fracture  of  the  sesamoid  bones.  Immediately  after 
these  accidents,  the  toe  of  the  foot  is  turned  up  ;  even  in  such 
a  case  the  sesamoids  are  not  moved  from  their  position,  but  the 
fixed  points  of  the  stay  are  destroyed. 

Sprain  of  the  suspensory  ligament  is  of  two  kinds,  namely — 
(1.)  An  inflamed  condition  arising  from  slight  causes ;  and  (2.) 
Eupture,  partial  or  complete,  from  more  violent  ones. 

In  the  first  form  there  will  be  lameness  ;  swelling  felt  along 
the  course  of  the  ligament ;  the  animal  standing  and  walking  on 
his  toe  as  much  as  he  can,  to  remove  all  tension  from  the  liga- 
ment ;  but  in  the  latter  form  the  fetlock  pads  descend  more  or 
less,  depending  upon  the  gravity  of  the  lesion. 

The  rupture  may  be  completely  through  the  substance  of  the 
ligament,  above  its  bifurcation,  or  one  of  the  branches  only  may 
be  lacerated,  above  its  attachment  to  the  sesamoid  bone ;  or  it 
may  be  detached  from  the  bone  without  transverse  rupture. 

This  lesion  occurs  both  in  the  fore  and  hind  extremities ;  in 
the  fore  extremities  of  race-horses  and  hunters,  and  more  com- 
monly in  the  hind  ones  of  horses  which  draw  heavy  loads.  It 
may  be  in  one  or  in  both  legs  at  the  same  time.  I  have  often 
seen  it  in  both  hind  legs  of  'bus  horses  in  hilly  districts. 

The  symptoms  are  descent  of  the  fetlock  pads,  turning  up  of 
the  toes,  with  heat  and  swelling  of  the  leg  or  legs.  The  lame- 
ness is  often  very  great,  the  animal  being  almost  unable  to 

move. 

The  injury  is  a  very  serious  one ;  but  with  a  long  rest  and 
proper  treatment  a  horse  so  injured  may  become  sufficiently 
sound  to  perform  moderate  work  for  many  years.  Yet  there 
is  always  a  weakness  left,  which  must  be  considered  an  un- 
soundness, as  it  may  at  any  time  cause  lameness,  particularly  if 
the  animal  be  called  upon  to  do  a  little  extra  work. 


SPRAIN  OF  SUSPENSORY  LIGAMENT.  283 

The  marks  of  the  lesion  always  remain  in  the  shape  of  a 
thickening,  which  may  be  felt  close  to  the  large  canon  bone,  or 
upon  any  part  of  the  course  of  the  ligament. 

Special  Treatment. — Patten  shoe  or  shoes,  if  they  can  be 
applied  and  borne ;  firm  pledgets  of  tow  placed  in  the  hollow  of 
the  heel  to  support  the  fetlock,  maintained  in  their  position 
by  firm  bandaging.  The  tow  should  be  made  into  a  firm  roll, 
the  fetlock  pad  elevated  by  an  assistant,  the  roll  of  tow  placed 
under  it  so  as  to  completely  fill  up  the  hollow  of  the  heel,  and 
fixed  in  that  position  by  a  bandage.  Other  bandages  should 
be  placed  round  the  leg  as  high  as  possible,  to  keep  the  parts 
together,  and  thus  diminish  the  breach  to  be  healed ;  cold 
applications  applied  until  the  inflammatory  symptoms  have 
subsided,  and  the  parts  firmly  reunited,  when  a  blister  may  be 
rubbed  on  to  remove  the  thickening  which  remains.  A  long 
rest  is  essential,  and  if  the  patient  will  not  lie  down  the  slings 
are  to  be  used. 

In  some  cases  of  injury  to  the  foot,  the  absorbents  of  the  leg 
become  swollen  and  inflamed.  This  must  not  be  confounded 
with  tendinous  or  ligamentous  injuries. 

SPRAIN  OF  THE  FETLOCK- JOINT. 

The  fetlock-joint  is  liable  to  inflammation  of  its  synovial 
membrane  from  a  variety  of  causes,  the  most  frequent  being 
sprain  of  one  of  its  lateral  ligaments.  In  comparison  with 
other  forms  of  lameness,  this  is  rare,  though,  from  the  fre- 
quency of  fracture  of  the  upper  extremity  of  the  os  suffraginis, 
entering  into  the  composition  of  the  joint,  one  would  be  in- 
clined to  conclude  that  the  concussion  which  so  often  produces 
fracture  would,  when  applied  in  a  more  limited  degree,  be  a 
frequent  source  of  inflammation ;  but  such  is  not  the  case.  It 
may  be  here  observed  that  squareness  of  the  fetlock,  obtained 
by  well-developed  tuberosities  on  the  os  suffraginis,  is  much  to 
be  desired,  a  round  fetlock  being  very  objectionable.  At  the 
same  time,  it  must  be  remembered  that  their  very  squareness 
renders  them  more  liable  to  fracture,  because  the  large  upper 
extremity  of  the  suffraginis  in  a  square  fetlock  is,  as  it  were,  un- 
supported by  the  body  of  the  bone. 

In  inflammation  of  the  fetlock-joint,  from  whatever  cause. 


284  PARTICULAE   LAMENESSES. 

the  lameness  is  characterised  by,  on  the  part  of  the  animal, 
inability  to  flex  it,  by  heat,  swelling,  pain  on  pressure,  and 
more  or  less  pointing  of  the  foot. 


SESAMOIDITIS. — INFLAMMATION  OF  THE  SESAMOID  BURSA. 

The  posterior  part  of  the  sesamoid  bones  is  covered  by  carti- 
lage, forming  a  groove,  over  which  the  flexor  perforans  plays. 
Boih  the  cartilaginous  pad  and  the  tendon  are  liable  to  injury, 
which  causes  severe  and  obstinate  lameness. 

Sesamoiditis  may  also  arise  from  an  injury  to  the  inferior  part 
of  the  suspensory  ligament — whether  involving  it  above  the 
bifurcation  or  confined  to  one  branch  only — ^by  extension  of  the 
inflammation ;  and  is  oftener  met  with  in  hunters  than  in  any 
other  class  of  horses. 

Sesamoiditis  is  not  so  often  found  in  the  fore  as  in  the  hind 
extremity,  and  is  rather  difficult  to  diagnose,  owing  to  the 
accompanying  swelling  being  very  limited  in  extent. 

The  pathology  is  as  follows : — 

1st.  Inflammation  of  the  bursa,  owing  to  sprain  or  other 
injury. 

2d.  Increased  secretion  into  the  sjmovial  cavity,  causing  a 
bulging  of  its  capsule  upon  either  side  of  the  flexor  tendon. 

Sd.  Ulceration  of  the  cartilage  of  incrustation,  softening  and 
laceration  of  the  fibres  of  the  tendon,  and,  finally,  adhesion 
between  the  bones  and  tendon, 

4:tJi.  When  arising  from  sprain  of  the  suspensory  ligament 
there  will  be  thickening  of  the  ligament  or  of  one  of  its  branches, 
associated  with  that  loss  of  cohesion  in  its  structure  which  seems 
so  characteristic  of  inflamed  ligament,  as  manifested  by  the 
animal  going  upon  the  heel,  and  descent  of  the  fetlock  pad. 

Symptoms. — Lameness,  the  horse,  unless  the  suspensory  liga- 
ment be  involved,  going  on  his  toe ;  heat  at  the  back  of 
tlie  fetlock,  with  swelling  of  the  bursa.  Tliis  swelling  is  diffe- 
rent in  its  character  from  a  mere  dropsy  of  the  bursa;  in 
sesamoiditis,  although  it  fluctuates  upon  pressure,  it  feels  tense, 
the  capsule  being  fully  distended  with  fluid ;  whereas  in  a  com- 
mon wind-gall  it  is  soft,  and  easily  pressed  from  one  side  of  the 
\Q(f  to  the  other.  This  diff'erence  in  the  character  of  the  two 
enlari^ements  must  be  remembered,  as  wind-galls  are*  often  found 


INFLAMMATION  OF  THE  SESAMOID  BUKSA. 


285 


involving  this  bursa.  The  hard  enlargement  of  sesamoiclitis 
is  an  unsoundness ;  the  soft  yielding  swelling  constituting  wind- 
galls  is  never  reckoned  as  such. 

This  bursa  is  often  the  seat  of  rheumatism. 

There  is  a  speciality  about  this  lameness  which  Professor 
Dick  was  very  particular  in  describing,  namely,  that  a  horse, 
after  a  period  of  rest,  may  trot  quite  sound  for  a  short  time ; 
that  he  is  liable  to  fall  lame  again  with  very  moderate  work ; 
and  that  the  lameness  is  most  obstinate  to  remove. 

An  injury  to  the  inferior  part  of  the  suspensory  ligament, 
whether  involving  it  above  the  bifurcation,  or  confined  to  one 
branch  only,  may  cause  sesamoiditis  by  extension  of  the  inflam- 
mation; but,  as  a  rule,  it  is  due  to  sprain  of  the  tendon  or 
injury  to  the  cartilage  of  incrustation. 

The  special  treatment  consists  in 
the  application  of  a  high-heeled  shoe, 
and  if  the  lameness  be  in  a  hind 
limb  and  very  severe,  placing  the 
animal  in  slings,  and  the  constant 
application  of  cold  water.  After  the 
subsidence  of  the  inflammation,  the 
absorption  of  the  enlargement  is  best 
effected  by  the  use  of  Mr.  Broad's 
truss. 

The  inferior  suspensory  ligaments 
of  the  sesamoid  bones  are  occasionally 
sprained,  causing  great  lameness,  the 
animal  going  on  the  toe,  with  swelling 
in  the  hollow  of  the  heel. 

In  some  rare  instances,  the  liga- 
mentous structures  in  this  part  of  the 
limb  have  been  converted  into  osseous 
material  (osteophytes),  forming  com- 
plete rings  round  the  tendons. — (See 
Photo-lithograph,  Plate  I.,  Fig.  4.) 


Fig.    44. — False  ring-bone, 
shown  at  a,  a. 


RING-BONES. 


This   term   is   applied   to    the   osseous   deposits   which   are 
found  upon   the    upper   and    lower  pastern    bones,  but   with 


286 


PARTICULAR  LAMENESSES. 


more  propriety  to  those  which  take  the  form  of  a  ring  round 

the  bone. 

Eing-bone  is  of  two  kinds,  true  and  false.  The  false  ring- 
bone may  be  dismissed  in  a  few  words ;  it  is  an  exostosis, 
situated  about  the  middle  of  the  os  suffraginis,  due  to  an  in- 
creased development  of  one  or  both  of  the  roughened  ridges  on 

this  bone,  which 
give  attachment  to 
the  sesamoidean 
ligaments.  When 
very  large,  it  may 
cause  lameness ;  as 
a  rule,  however,  it 
never  gives  incon- 
venience to  the 
animal,  and  is  not 
always  to  be  look- 
ed upon  as  a  cause 
of  unsoundness.  It 
may  be  compared 
to  a  splint  thrown 
out  for  some  bene- 
ficial purpose. 

The   true   ring- 
bone is  quite  an- 
other matter,  and 
^:^=^        is  an  unsoundness 
'■_-^^    in  every  sense  of 
^^^     the  word,  involv- 
^^^^  ing  important  arti- 
_^?W^    culations,  and  giv- 
-ir_       ing  rise  to  obsti- 
nate, and  often  in- 
curable, lameness. 
There    are  two 


Fig.  45. — High  ring-bone. 


kinds  of  true  ring-bone,  the  high  and  the  low  ;  it  is  called  high 
when  it  involves  the  proximal  inter-phalangeal  articulation  or 
pastern  joint ;  and  low,  when  it  involves  the  distal  inter-phalan- 
geal articulation  or  coffin  joint.  In  many  instances  both  forms 
exist  at  the  same  time.     Photo-lithograph,  Plate  III,  Pig-  5,  is 


a  good  illustration  of  tliis. 


EING-BONES. 


287 


Eing-bone  must  not  be  confounded  with  what  is  termed  side- 
bone  ;  the  first  is  a  bone  disease,  the  second  a  disease  of  fibro- 
cartilage. 

Ring-bones,  whether  high  or  low, 
vary  in  size ;  but  the  degree  of  lame- 
ness does  not  depend  upon  the  mere 
size  of  the  new  formation.  An  animal 
may  be  very  lame,  indeed,  with  but 
little  osseous  deposit;  and  another 
may  show  but  little  lameness,  with  a 
very  large  ring-bone. 

Very  often  the  segment  of  the  ring 
is  defective,  and  the  deposit  may  ap- 
pear only  on  one  surface  of  the  limb, 
or  on  both  sides  without  any  promi- 
nence in  the  front.  When  at  the 
sides,  they  do  not  cause  the  same  de- 
gree of  lameness  as  when  the  front  is 
involved. 

Eing-bones  are  not  the  cause,  but 
the  result  of  disease,  being  the  effect 
of  an  inflammation  originating  in  the 
extremities  of  the  bones,  or  synovial 
membranes  of  the  articulations  which 
they  involve.  As  a  rule,  they  are  the 
result  of  ostitis,  commencing  in  the 
cancellated  structure  of  the  bones,  the 
areolae  of  which  first  became  filled 
with  an  organizable  lymph,  convertible 
into  bony  material,  as  already  de- 
scribed.— (See  Ostitis,  p.  151.)  During 
the  progress  of  the  inflammation,  the 
articular  cartilage  and  laminal  layer 
of  the  end  of  the  bones  become  re- 
moved by  absorption,  while  external 
to  the  joint  active  deposition  of  bony 
material  is  going  on,  for  the  purpose 
of  repairing  the  damage  within. 

In  some  instances  the  disease  may  commence  at  the  inferior 
extremity   of   the   os   suffraginis,   and    gradually  involve    the 


Fig.  46.  — Lowering-bone. 


Fig.  47. 


288  PARTICULAE  LAMENESSES. 

articulation  and  os  coronae.  The  accompanying  figure  (Fig.  47) 
illustrates  this.  When  involving  either  articulation,  ring-bone 
always  causes  lameness  at  its  commencement ;  but  when  anchy- 
losis is  completed,  such  lameness  may  almost,  if  not  entirely, 
disappear. 

The  lameness  of  ring-bone  precedes  the  deposition  of  bony 
matter,  and  is  due  to  the  presence  of  inflammation  in  the  bones 
or  synovial  membrane. 

The  gait  of  a  horse  lame  from  this  cause  is  characteristic. 
If  in  the  fore  extremity,  except  the  deposit  be  on  the  posterior 
aspect,  the  patient  puts  his  heel  to  the  ground  first ;  but  when 
in  the  hind  pastern,  the  toe  touches  the  ground  first  always 
when  it  is  situated  in  the  upper  position,  except  it  be  in  front ; 
when  in  the  lower  position,  the  heel  comes  down  first.  From 
this  peculiarity  in  putting  the  foot  to  the  ground,  it  is  apt  to  be 
confounded  with  laminitis,  seedy-toe,  and  inflammation  of  the 
coronary  band.  It  differs  from  laminitis  by  the  absence  of  pain 
at  the  toe,  freedom  from  fever,  &c.,  and  by  the  heat  being  con- 
fined to  the  upper  part  of  the  foot  only. 

An  examination  of  the  foot  will  determine  whether  there  be 
a  seedy-toe  or  a  sand-crack  in  its  front ;  and  the  absence  of  the 
striated  appearance  of  the  wall  of  the  foot  w^ill  distinguish  it 
from  inflammation  of  the  coronary  substance. 

Percivall,  writing  in  the  year  1823,  has  thus  classified  150 
specimens  of  ring-bone.  He,  however,  includes  anchylosis  of 
the  fetlock-joint  under  the  term: — 

5  complete  anchyloses  of  the  fetlock-joint. 
40         „  „  „      pastern-joint. 

18         „  .   ,.  „       coffin-joint. 

The  other  specimens  were  simply  encrusted,  more  particularly 
around  their  extremities,  with  layers  of  new  bone,  or  were 
variously  deformed  with  exostoses  of  different  shapes,  many  of 
which  were  very  large,  and  several  of  them  confined  to  one  side. 

My  own  observations  upon,  and  examinations  of,  specimens 
enable  me  to  agree  with  Percivall,  and  to  differ  from  Professor 
Dick  and  others,  who  maintained  that  the  lower  form  was  the 
most  common. 

The  causes  of  ring-bone  are  hereditary,  structural,  incidental, 
and  rheumatoid. 

Hereditary  predisposition  is  sufficiently  proved  and  acknow- 


RING-BONES.  289 

ledged;  I  therefore  simply  advise  breeders  of  horses  never  to 
breed  from  a  sire  or  dam  having  ring-bones,  unless  their  origin 
can  be  readily  traced  to  some  accidental  cause. 

The  structural  tendency  to  ring-bone  is  manifested  in  horses 
with  upright  pasterns.  Percivall  explains  this  in  nearly  the 
following  words : — 

"  The  pastern  and  coffin  bones  constitute  the  nethermost 
parts,  the  pedestals  of  the  columns  of  bones  composing  the 
limbs ;  and  being  so,  they  receive  the  entire  weight  and  force 
transmitted  from  above.  The  pastern,  when  long  and  oblique 
in  position,  receives  the  superincumbent  weight  in  such  an 
indirect  line  that,  bending  towards  the  ground  with  the  fetlock, 
nothing  like  jar  or  concussion  follows.  The  very  reverse  of 
this,  however,  is  likely  to  happen  every  time  the  foot  of  a  limb 
having  a  short  and  upright  pastern  comes  to  the  ground.  In 
it,  instead  of  the  weight  descending  obliquely,  it  descends 
directly  upon  the  pastern  bones,  making  them  entirely  depen- 
dent upon  the  pedal  bone  for  counteractive  spring ;  and  should 
anything  occur  to  destroy  or  diminish  this  spring,  or  to  throw 
more  weight,  or  weight  more  suddenly,  upon  it  than  it  can 
counteract,  jar  of  the  whole  apparatus  ensues ;  and  an  effort  of 
nature  to  strengthen  the  parts,  by  investing  them  with  calhis 
and  ossification,  is  likely  to  be  the  ultimate  result.  For  w^e 
would  view  ring-bone,  disease  though  it  most  assuredly  must 
be  called,  frequently  in  young  horses,  as  a  resource  nature 
seems  invariably  to  adopt  whenever  the  pastern  bones  and 
joints  are  found  unequal  to  the  exertions  or  efforts  required  of 
them.  And  the  reason  why  ring-bone  occurs  oftener  in  the 
hind  than  in  the  fore  limb  will  probably  be  found  in  the  greater 
stress  or  strain  the  hind  pasterns  undergo  in  unbacked  young 
horses,  particularly  in  such  acts  .as  galloping,  jumping,  &c., 
exercises  which  they  are  likely  to  take  of  their  own  accord 
while  running  out  at  pasture." 

In  the  treatment  of  ring-bone  care  must  be  taken  to  observe 
how  the  patient  places  the  foot  on  the  ground.  In  the  fore  leg 
he  always  puts  the  heel  down  first,  in  order  to  throw  the  weight 
of  his  body,  and  the  consequent  concussion  from  the  column  of 
bones,  on  to  the  soft  parts.  In  such  a  case  a  thin-heeled  bar- 
shoe  must  be  put  on  the  foot — the  shoe  recommended  by  my 
friend  Mr.  Broad  of  Bath  for  laminitis.     This  gives  great  relief 

u 


290  PARTICULAR  LAMENESSES. 

by  allowing  the  animal  to  throw  its  weight  upon  the  heels 
with  the  least  possible  effort.  I  have  many  cases  of  ring-bone 
at  the  present  time,  where  the  horses  go  moderately  sound  with 
such  a  shoe,  that  would  be  unworkably  lame  if  shod  in  the 
ordinary  way. 

If  the  horse  walks  on  his  toe,  he  must  be  shod  with  a  high- 
heeled  shoe.  This  only  occurs  when  ring-bone  is  situated  in  the 
hind  limbs,  and  on  the  sides  or  back  of  the  pastern ;  when  in 
front,  the  horse  will  go  on  his  heel,  and  is  to  be  shod  with  the 
low- heeled  shoe. 

Very  long  pasterns,  from  the  fact  that  they  act  too  powerfully 
as  levers  upon  the  articulations,  are  subject  to  ring-bones;  in 
such  cases,  I  think  that  they  arise  from  sprain  of  the  ligaments. 
This  occurs,  as  a  rule,  in  the  hind  legs,  and  for  this  reason,  the 
horse  lame  from  this  cause  throws  his  weight  upon  the  column 
of  bones  by  walking  on  the  toe. 


CHAPTER  XY. 

PARTICULAR  LAMENESSES — continued. 

HIP-JOINT    LAMENESS — SPRAIN    OF   GLUTEAL    TENDONS,   OR   TROCHAN- 
TERIC LAMENESS SPRAIN  AND  ATROPHY  OF  CRURAL  MUSCLES 

STIFLE-JOINT    LAMENESS LACERATION     OF    FLEXOR    METATARSI 

MUSCLE. 

Hip- Joint  lameness  is  of  very  rare  occurrence,  except  as  a  result 
of  the  scrofulous  diathesis  in  young  animals,  and  of  rheumatism 
in  those  of  mature  age.  Sprain  of  the  hip-joint  is  very  rare 
indeed,  but  it  is  possible ;  and  when  inflammation  of  the  joint 
occurs  from  this  cause,  the  same  pathological  changes  are 
observed  as  in  other  joints,  namely,  redness  of  the  synovial 
membrane,  exudation  into  the  cavity,  and  if  not  arrested,  ulcera- 
tion of  the  articular  cartilage  and  laminal  layer  of  the  bones. 
In  rheumatoid  disease,  the  tendency  is  to  the  formation  of  the 
porcellaneous  deposit  within,  and  bony  vegetations  around,  the 
articulations. 

Lameness  in  the  Tiip,  however,  is  not  at  all  an  unfrequent 
occurrence ;  still  its  seat  is  not  the  joint,  but  the  head  of  the 
trochanter  major  of  the  lemur. 

"  The  trochanter  major  is  a  very  large  eminence  which  looks 
outwards  and  upwards,  and  presents,  posteriorly,  a  prominent 
part,  termed  the  summit,  which  stands  a  little  higher  than  the 
articular  head  (of  the  femur),  and  gives  attachment  to  one  of  the 
heads  of  the  gluteus  maximus;  and  anteriorly  the  convexity, 
which  is  rounded  and  covered  externally  by  cartilage  of  incrus- 
tation, which  forms  a  bursa,  over  which  plays  the  other  tendon 
of  the  gluteus  maximus,  which  becomes  inserted  into  the  ridge 
just  below." — (Strangeways'  Anatomy) 

The  above  quotation  will  enable  the  reader  to  understand  that 
the  trochanter  major  is  a  very  important  protuberance ;  that  it 


292 


PARTICULAR  LAMENESSES. 


is  a  very  strong  lever,  to  which  the  tendons  of  powerful  muscles 
are  attached ;  that  it  has  to  assist  extensive  movements,  and,  in 
accordance  with  the  importance  and  extent  of  its  functions,  it  is 
liable  to  injury  and  disease. 

Sprain  of  the  tendon  of  the  gluteus  maximus  gives  rise  to 
inflammation  of  the  synovial  bursa  on  the  convexity  of  the 
trochanter,  as  well  as  in  the  substance  of  the  tendon.  The 
summit  is  liable  to  injury  from  blows  or  falls,  and  the  inflam- 
mation so  produced  extends  to  the  convexity.  From  whatever 
cause  the  inflammation  arises,  and  whether  it  originates  at  the 

summit  or  the  convexity  of  the 
trochanter,  the  exudate  which  is 
formed  is  apt  to  be  converted 
into  osseous  material,  and  the 
cartilage  of  incrustation  on  the 
convexity  to  be  removed  by  ul- 
ceration.— (See  Fig.  48.) 

Violent  inflammation  of  the 
hip-joint  is  accompanied  by  very 
severe  symptoms ;  and  the  animal 
wdll  stand  almost  immoveable, 
with  the  foot  raised  from  the 
ground,  in  which  position  it  will 
be  steadily  maintained,  unless 
he  is  forced  to  move ;  all  move- 
ment increasing  pain  to  an  agon- 
ising extent.  There  will  be 
fever,  loss  of  appetite  and  flesh, 
rapid  wasting  of  the  quarter,  and 
inability  to  lie  down.  In  such  a 
case  the  animal  must  be  slung. 

The   dissection   of    such   cases 
generally  reveals  ulceration  or  la- 
ceration of  the  ligamentum  teres, 
Fig.    48.-Di8ea8e   of  trochanter  ulceration  of  the  articular  carti- 

major,  debcnbecl  an  the  text. 

lage,  both  on  the  head  of  the 
femur  and  cotyloid  cavity,  with  suppuration  into  the  cavity  of 
the  joint,  or  partial  destruction  of  it  by  a  deposition  of  bony 
matter.  I  have  never  witnessed  anchylosis  of  this  joint,  but  I 
have  a  specimen  where  the  acetabulum  is  almost  filled  with 


HIP-JOINT  LAMENESS.  293 

bony  material.  If  the  severe  symptoms  do  not  soon  abate, 
the  practitioner  will  understand  that  the  above  pathological 
changes  are  going  on,  and  that  the  horse  will  remain  incurably 
lame. 

The  symptoms  of  a  milder  form  of  hip-Joint  lameness,  and 
of  that  arising  from  disease  of  the  trochanter,  do  not  differ  in 
any  peculiarity  of  gait.  There  is  a  hop  and  a  catch  in  the  lame 
limb,  and  a  want  of  movement  in  the  quarter,  which  to  a  prac- 
tised eye  is  quite  suggestive.  The  whole  of  the  quarter  on  the 
lame  side  is  elevated  with  as  little  motion  of  the  hip  as  possible; 
the  other  articulations  being  flexed  with  ease.  While  standing, 
the  foot  of  the  lame  limb  in  severe  cases  will  often  be  elevated 
from  the  ground ;  the  muscles  below  the  seat  of  disease  exert- 
ing themselves,  as  it  were,  to  support  the  weight,  and  thus 
allowing  the  gluteals  to  be  in  a  state  of  relaxation.  In  hip- 
joint  lameness  heat  may  be  felt,  and  pain  caused,  in  some  cases, 
by  pressure  applied  per  rectum.  In  trochanteric  lameness,  a 
distinct  swelling  can  be  detected,  both  by  touch  and  sight, 
upon  the  quarter.  In  both  forms,  atrophy  of  the  muscles  of 
the  quarter  soon  manifests  itself,  and  is  apt  to  lead  the  prac- 
titioner to  confound  the  disease  with  fracture;  but  in  disease 
the  wasting  and  inequality  of  the  quarter  appear  after  the 
animal  has  been  lame  for  some  little  time,  whilst  in  fracture 
they  are  seen  immediately  after  the  displacement  of  the  bones. 

The  swelling  of  trochanteric  lameness  is  of  an  irregular 
roundish  shape,  on  the  very  point  of  what  is  erroneously  called 
the  hip-joint ;  hot  to  the  touch,  and  painful  upon  pressure.  To 
see  it  distinctly,  the  practitioner  should  stand  both  behind  and 
at  the  side  of  the  patient,  as  the  shades  of  light  sometimes  hide 
it  from  observation. 

In  the  treatment  of  either  form,  the  high-heeled  shoe  is 
to  be  put  on  the  foot,  to  enable  the  parts  to  be  maintained  in 
a  state  of  repose.  The  patient  requires  a  long  rest,  since  the 
lameness  is  very  apt  to  return ;  and  in  this,  as  well  as  in  other 
lamenesses,  treatment  should  be  resorted  to,  and  rest  imposed, 
before  alteration  of  structure  has  taken  place.  Even  when  all 
signs  of  lameness  have  disappeared,  great  care  must  be  taken 
not  to  work  the  animal  too  soon. 

The  horses  most  subject  to  this  lameness  are  those  which  draw 
heavy  loads,  and  care  must  be  taken  that  they  are  not  forced 


294  PARTICULAR  LAMENESSES. 

to  this  too  soon  after  apparent  cure,  or  it  will  most  assuredly 
cause  a  return  of  the  lameness.  Another  fact  should  be  remem- 
bered, namely,  that  a  high  toe-piece  on  the  shoe,  by  increasing 
the  resistance  to  the  action  of  the  muscles  of  the  limb,  may  cause 
this,  as  well  as  many  other  forms  of  lameness. 


SPRAIN  AND  ATROPHY  OF  THE  CRURAL  MUSCLES. 

That  mass  of  muscular  structure  known  as  the  crural  muscles 
is  liable  to  sprain.  It  consists  of  the  rectus  femoris,  arising  from 
the  ilium ;  the  vastus  externus  and  internus,  arising  from  the 
superior  part  of  the  femur ;  and  the  crureus,  arising  from  the 
lower  half  of  the  femur.  Their  muscular  structure  is  very 
intimately  blended,  and  they  finally  become  inserted  into  the 
superior  surface  of  the  patella.  Their  action  is  to  extend  and 
elevate  the  thigh,  and  advance  it  under  the  body. 

The  symptoms  of  injury  or  sprain  of  these  muscles  are  inability 
to  extend  the  stifle  and  flex  the  hock,  in  fact  to  draw  the  limb 
forward ;  dragging  of  the  toe  when  the  patient  moves ;  when 
standing  still,  the  patella  seems  to  have  slipped  down,  and 
there  is  knuckling  over  of  the  fetlock-joint,  the  whole  limb 
being  posterior  to  its  fellow.  After  a  time  the  muscular  struc- 
tures become  atrophied,  individual  muscles  become  prominent, 
and  a  concavity  presents  itself  between  the  anterior  spine  of  the 
ilium  and  the  patella. 

Since  the  introduction  of  tramways,  this  form  of  injury  has 
become  more  common,  owing  to  horses  slipping  on  the  rails. 
This  form  of  lameness  requires  long  rest. 

STIFLE-JOINT  LAMENESS 

Is  of  two  kinds,  namely,  that  within  the  joint  proper,  involv- 
ing the  condyles  of  the  femur,  the  semi-lunar  discs,  and  articular 
head  of  the  tibia  (see  Photo-lithograph,  Plate  II.,  Fig.  3) ;  and 
that  in  the  patella  articulation.  The  pathology  of  both  forms 
is  alike — inflammation,  ulceration  of  the  articular  cartilage  and 
of  the  semi-lunar  discs,  when  the  joint  proper  is  involved,  of  the 
deposition  of  the  porcellaneous  deposit,  both  in  the  cartilage  and 
Haversian  canals  of  the  bones,  when  caused  by  rheumatoid  disease. 
In  stifle-joint  lameness,  the  limb,  when  the  animal  stands, 


STIFLE-JOINT  LAMENESS.  295 

is  generally  bent,  the  thigli  flexed  upon  the  pelvis,  and  the 
leg  upon  the  thigh,  so  that  the  articular  surfaces  of  the  bones 
are  separated,  and  prevented  from  pressing  against  each 
other;  but  when  made  to  move,  the  relative  positions  of  the 
various  bones  are  altered,  and,  instead  of  being  flexed,  the 
stifle  is  maintained  in  a  rigidly  extended  state.  In  this 
manner  the  joint  is  locked,  its  movements  suspended,  and,  as 
a  result,  the  heel  of  the  foot  touches  the  ground  first.  This  is 
more  especially  the  case  when  the  posterior  part  of  the  joint  is 
diseased. 

In  lameness  from  disease  of  the  bursa-patellae,  the  horse 
generally  walks  with  his  toe  dragging  the  ground,  as  if  he 
were  afraid  to  bring  the  rectus  femoris  and  vasti  muscles  into 
action  to  elevate  the  patella  on  the  trochlea  of  the  femur ;  the 
forward  movement  of  the  limb  being  performed  with  great 
difficulty,  the  toe  of  the  foot  describing  the  segment  of  a  circle 
at  each  step.  These  symptoms  are,  however,  not  constant; 
some  cases  of  well-marked  patella  lameness  put  the  heel  to  the 
ground  first.  But  in  aU  instances  the  position  while  stand- 
ing is  that  of  semi-flexion,  this  being  the  best  calculated  to 
insure  separation  of  the  various  articular  surfaces,  and  prevent 
pressure. 

Dissection  of  stifle-joint  lameness  reveals  a  condition  of  in- 
flammation of  the  synovial  membranes,  of  the  condyles  of  the 
femur,  and  the  articular  head  of  the  tibia;  degeneration  into 
shreddy  masses  of  the  semi-lunar  discs,  laceration  of  their  liga- 
ments, removal  of  the  articular  cartilage,  or  its  calcification  and 
removal  by  friction. 

When  confined  to  the  bursa-patellae,  the  alterations  of  struc- 
ture consist  in  the  removal  of  the  articular  cartilage  from  the 
patella  and  trochlea  of  the  femur,  aind  thickening  of  the  synovial 
membrane  from  interstitial  inflammatory  exudation. 

The  bursa-pateUse  is  situated  superficially,  and  when  in- 
flamed the  increased  secretion  poured  into  it  causes  a  swelling 
in  front  of  the  joint.  This  swelling  must  not  be  confounded 
with  an  apparent  enlargement  of  this  part,  seen  in  the  healthy 
stifle  when  the  animal  stands  with  the  limb  in  a  semi-flexed 
easy  position,  when  "he  stands  resting  it,"  as  it  is  commonly 
called.  The  swelling  arising  from  disease  is  persistent,  hard, 
and  prominent  when  the  limb  is  extended;   but  the  enlarge- 


296  PARTICULAR  LAMENESSES. 

ment  arising  from  the  parts  being  thrown  into  a  state  of  rest 
and  relaxation  is  soft,  and  disappears  when  the  horse  is  made  to 
stand  firmly. 

Professor  Dick  said  that  stifle-joint  lameness  could  be  detected 
by  pressing  upon  either  side  of  the  internal  lateral  ligament,  and 
that  a  swelling  could  be  felt  caused  by  the  distension  of  the 
capsular  ligament  with  synovia.  I  have  never  been  able  to  con- 
firm this,  and  have  been  compelled  to  be  satisfied  with  negative 
symptoms  and  the  gait. 

Belaxation  of  the  patella  arises  from  sprain  and  inflammation 
of  the  lateral  ligaments,  which  thus  become  elongated  and  allow 
of  partial  dislocation  of  the  patella.  The  symptoms  and  treat- 
ment are  similar  to  those  recommended  for  luxation  (described 
at  page  143,  which  see). 

The  muscles  of  the  stifle  are  subject  to  cramp,  the  symptoms 
being  very  similar  to  those  of  dislocation  of  the  patella,  the 
limb  being  extended  and  fixed  to  the  ground.  It  comes  on 
and  goes  off  suddenly.  I  have  known  such  to  arise  from  in- 
digestion, and  the  liability  to  its  return  to  be  completely  re- 
moved by  one  or  two  doses  of  purgative  medicine  and  alteration 
of  diet. 

Subcutaneous  laceration  of  the  flexm^  metatarsi  muscle  is  occa- 
sionally a  cause  of  lameness.  Professor  Dick  had  seen  some- 
thing of  it.  He  used  to  refer  to  it  in  his  lectures  as  presenting 
symptoms  similar  to  paralysis  of  the  gastrocnemii.  He  used  to 
say  that  when  the  flexor  metatarsi  muscle,  any  muscles  situated 
at  the  anterior  part  of  the  stifle  or  the  gastrocnemii  were  injured, 
the  tendo-achilles  fell  into  a  relaxed  condition  when  the  limb 
was  elevated  from  the  ground. 

Figure  49  is  from  life,  drawn  by  Professor  Vaughan,  when 
a  student  of  the  College.  The  horse  was  an  ill-looking 
long-legged  cart-horse,  very  subject  to  rheumatic  attacks,  for 
which  Mr.  Cunningham  of  Slateford  had  repeatedly  attended 
him.  Towards  the  end  of  1871  he  was  found  one  morning  to 
be  very  lame,  and  when  he  attempted  to  move,  the  near  hind 
leg  was  thrown  upwards  and  backwards  with  great  violence ;  at 
the  same  time  the  tendo-achilles  was  seen  to  fall  into  a  num- 
ber of  folds.  Upon  the  limb  being  elevated  by  the  hand,  the 
same  seemingly  powerless  condition  of  the  gastrocnemii  was 
observed.      The  limb  was  swollen  above  and  in  front  of  the 


LACERATION  OF  FLEXOR  METATARSI  MUSCLE. 


297 


hock,  midway  between  it  and  the  patella.  The  horse  being  old 
and  not  of  much  value,  the  owner,  at  the  suggestion  of  Mr. 
Cunningham,  sent  him  to  the  College  for  dissection,  when  it 


Fig.  49. 

was  discovered  that  the  flexor  metatarsi  was  lacerated  across 
its  whole  thickness,  at  a  point  corresponding  to  the  external 
swelling;  its  fibres  were  pale,  and  when  examined  under  the 
microscope  their  tranverse  strise  were  nearly,  and  in  some 
places  entirely,  absent,  showing  that  the  sarcous  elements  w^ere 
undergoing  degeneration.  I  have  met  with  other  instances  of 
the  same  lesion,  but  never  had  the  opportunity  of  making  a  dis- 
section of  the  parts  prior  to  this.  As  to  the  probability  of 
repair,  I  think  that,  provided  the  animal  be  not  too  old,  the 
chances  of  recovery  are  very  good,  and  that  in  the  course  of 
time  reunion  of  the  divided  muscle  may  be  expected;  but 
should  the  horse  be  old,  or  of  a  weak  constitution,  the  pro- 
babilities are  that  the  rupture  is  a  result  of  degenerative 
disease  of  the  muscular  tissue,  and  not  a  mere  accident,  and 


298  PARTICULAR  LAMENESSES. 

that  the  process  of  repair  will  be  very  doubtful  and  unsatis- 
factory. 

This  peculiar  lameness  is  not  always  due  to  rupture  of  the 
flexor  metatarsi  muscle,  as  in  the  case  just  described,  for  it  some- 
times happens  that  its  tendons  of  insertion  become  detached  from 
the  tarsal  and  metatarsal  bones.  Such  cases  are  diagnosed  by 
the  peculiar  gait  and  the  seat  of  the  swelling. 


CHAPTEE  XVI. 

PARTICULAR  LAMENESSES — Continued, 

DISEASES   OF  THE  HOCK BOG-SPAVIN BONE-SPAVIN — CONFORMATION 

OF    HOCK    MOST    SUBJECT    TO    SPAVIN — THOROUGH-PIN CAPPED 

HOCK — INJURIES   TO  GASTROCNEMII  MUSCLES — CURB. 

DISEASES  OF  THE  HOCK. 

The  tarsus  or  hock  corresponds  to  the  ankle-joint  of  man.  Its 
diseases  may  be  divided  into  three  classes,  namely — (1.)  Dis- 
eases of  the  true  hock-joint  (that  composed  of  the  tibia  and 
astragalus) ;  (2.)  Diseases  of  the  gliding  articulations  formed  by 
the  cuneiform  bones ;  and  (3.)  Diseases  of  its  ligamentous  and 
tendinous  structures. 

L   DISEASES  OF  THE  TRUE  HOCK-JOINT. 

Bog-Spavin. — A  bog-spavin,  when  caused  by  inflammation  of 
the  joint,  is  a  tense,  fluctuating  swelling,  accompanied  by  heat 
and  pain.  In  such  instances  it  is  an  unsoundness  indicating  a 
change  within  the  textures  of  the  joint.  There  are  bog-spavins, 
however,  which  may  not  be  looked  upon  as  constituting  unsound- 
ness, being  mere  dropsy  of  the  articulation,  arising  from  some 
fault  of  conformation.  Professor  Dick  maintained  that  such 
collections  were  "  mere  stores  of  synovia  for  lubricating  the  joint, 
thus  proving  the  best  preventatives  of  disease,  by  preventing 
friction."  These  kinds  of  bog-spavins  are  most  frequently  found 
in  very  upright  or  in  very  crooked  hocks,  and  in  weak  hocks  of 
any  description ;  because  in  all  these  forms  concussion  is  most 
severely  felt,  and  exertion  is  likely  to  be  injurious.  In  all 
probability  the    hyper-secretion   of   synovia  is   due  to   some 


300  PARTICULAR  LAMENESSES. 

irritation  not  amounting  to  actual  disease,  and  may  be  viewed 
as  a  provision  of  nature  to  fulfil  the  purposes  ascribed  to  it  by 
Professor  Dick,  since  it  often  happens  that  such  hocks  remain 
sound  as  long  as  those  of  a  better  conformation.  They  should, 
however,  be  looked  upon  with  suspicion,  and  the  practitioner 
ought  at  all  times  to  satisfy  himself  by  a  severe  trial  that  such 
hocks  are  able  to  bear  a  reasonable  amount  of  exertion ;  that  the 
swelling  does  not  increase  after  such  test,  and  that  the  animal 
be  neither  stiff  nor  lame  in  the  slightest  degree. 

Inflammation  of  the  true  hock-joint  may  be  acute  or  chronic. 
In  the  acute  form  the  lameness  is  very  great,  with  fever,  loss  of 
condition,  and  inability  to  put  the  foot  to  the  ground.  It  is  apt 
to  terminate  in  ulceration  of  the  articular  cartilage  and  a  partial 
anchylosis  of  the  joint. 

A  very  constant  condition  of  the  joint  in  the  chronic  form 
of  bog-spavin,  and  probably  the  cause  of  it,  is  the  gradual  con- 
version of  the  articular  cartilage  into  calcareous  matter — the 
ivory  or  porcellaneous  deposit. —  (See  Photo-lithograph,  Plate 
II.,  Fig.  5.)  This  condition  is  associated  with  the  rheumatoid 
diathesis  ;  and  not  only  is  there  a  deposit  in  the  cartilage,  but 
also  in  the  synovial  fringes,  which  are  converted  into  hard 
rounded  nodules  of  calcareous  matter.  Common  inflammation 
of  a  joint  generally  tends  to  ulceration  and  anchylosis ;  the  rheu- 
matoid, to  calcification  of  the  articular  cartilage  and  synovial 
fringes. 

The  sulci  of  the  hock-joint  should  not  be  confounded  with 
ulcers. 

When  articular  cartilage  has  been  calcified,  or  converted  into 
the  ivory-like  deposit,  it  no  longer  prevents  the  effects  of  the 
friction  arising  from  the  movements  of  the  bones  upon  each 
other.  A  careful  examination  of  Photo-lithograph,  Plate 
II.,  Figs.  3  and  5,  will  at  once  demonstrate  this,  for  it  will  be 
seen  that  the  articular  heads  of  the  bones  are  worn  down, 
leaving  well-marked,  and,  in  the  hock,  deep  grooves  upon 
them.  The  polished  appearance  given  to  the  diseased  part 
was  attributed  by  Professor  Dick  to  the  effect  of  friction  on 
bone  otherwise  unchanged;  but  a  more  careful  examination 
has  shown  that  it  is  due  to  an  actual  formation  of  a  very 
hard,  earthy  matter  in  the  Haversian  canals,  for  the  purpose 
of  counteracting  and  limiting  the  effects  of  friction,  and  that 


DISEASES  OF  THE  HOCK.  301 

its  glistening,  polished  appearance  is  undoubtedly  due  to  the 
friction. 

What  is  termed  a  Uood-spamn  is  simply  a  distended  con- 
dition of  the  vena-saphena,  caused  by  the  pressure  of  a  bursal 
or  bony  enlargement.  It  has  been  described  as  a  disease  of 
the  vein,  and  in  some  rare  instances  a  varicosity  has  actually 
existed. 

In  rheumatoid  diseases  of  the  hock-joint,  the  crackling  sound 
caused  by  the  first  movements  of  the  articulation,  already 
described,  has  been  noticed  by  some  veterinarians.  Thus,  the 
late  Mr.  Farrel  of  Dublin  was  able  to  prognosticate  the 
incurability  of  hock-joint  disease  when  it  was  accompanied 
by  that  sound. 

What  is  commonly  called  a  "sprung  JiocW  is  an  enlarged  and 
inflamed  condition  of  the  tarsus  generally,  involving  the  struc- 
tures of  the  whole  articulation,  arising  from  severe  sprain,  and  in 
some  instances  associated  with  fracture  of  one  or  more  of  the 
smaller  bones. 

This  injury  causes  extreme  lameness,  and  fever ;  prevents  the 
animal  from  lying  down  and  taking  its  natural  rest ;  and  is 
thus  a  cause  of  rapid  loss  of  condition,  and  sometimes  of  death. 

The  special  treatment  is  that  calculated  to  allay  irritability, 
fever,  and  the  local  pain;  and  in  order  that  the  animal  may 
obtain  some  degree  of  rest  the  slings  are  essential ;  and  when 
the  acute  symptoms  have  subsided,  repeated  applications  of  the 
biniodide  of  mercury  ointment  to  stimulate  the  absorption  of 
the  callous  enlargements,  and  perhaps  setons  or  the  actual 
cautery  to  remove  any  remaining  lameness. 

II.   DISEASES  OF  THE  GLIDING  AETICULATIONS  OF  THE  HOCKS. 

Bone- Spavin. — Bone-spavin  is  a  very  common  cause  of  lame- 
ness and  unsoundness,  and  it  is  of  importance  that  a  veterinary 
surgeon  be  a  good  judge  of  a  hock ;  for  what  may  be  a  spavin  in 
one  horse  may  be  a  mere  peculiarity  of  conformation  in  another. 

Definition. — The  derivation  of  the  word  spavin  is  buried  in 
obscurity ;  but  it  is  thought  by  some  to  be  derived  from  the 
Italian  spavenio,  a  disease  of  horses — an  unsatisfactory  ex- 
planation. I  find,  however,  that  Eokitansky  describes  a  lamellar 
bony  tumour  as  "  spavined ; "  possibly  the  word  may  have  some 
connection  with  that  form  of  exostosis.     A  bone-spavin  may  be 


302 


PARTICULAR  LAMENESSES. 


defined  to  be  an  exostosis  on  the  inner  and  lower  part  of  the 
hock,  arising  from  inflammation  of  the  cuneiform  and  metatarsal 
bones,  terminating  generally  in  anchylosis  of  one  or  more  of  the 
gliding  joints  of  the  hock. 

Why  spavin  should  generally  appear  on  the  inner,  and  but 
rarely  on  the  outer  side  of  the  hock,  can  be  explained  by  satis- 
factory reasons.  1st.  The  inner  side  of  the  limb  is  more  under 
the  central  line  of  gravity:  2d.  From  the  arrangement  of  the 

cuneiforms,  and  especially  the  direc- 
tion of  the  articular  surface  of  the 
astragalus,  the  hock  is  so  constructed 
that  when  the  limb  is  flexed  the 
pressure  and  consequent  concussion 
is  thrown  on  the  inner  side.  Pro- 
fessor Goodsir  maintained  that  a 
screw-like  motion  of  the  true  hock- 
joint,  acting  unfavourably  on  the 
cuneiforms  and  metatarsals,  was  the 
cause  of  spavin.  Professor  Barlow 
said  spavin  was  due  to  compression 
of  the  cuneiforms  during  extreme 
flexion.  Other  pathologists  maintain 
that  concussion,  produced  when  the 
foot  comes  forcibly  to  the  ground, 
is  the  sole  cause.  It  is  not  my  in- 
tention to  discuss  which  theory  is 
correct.  In  all  probability  they  are 
all  more  or  less  so. 

Bone-spavin    is    but    very   rarely 
found  on  the  outer  side  of  the  hock. 

Fig.    50. — Showing   situation    -n-n  j-ia-i,  u        j-v 

of  bone-spavin,  a  shallow  groove  Percivall  says  that  he  would  not  be 
being  left  in  the  ossific  deposit  gure  "  that  an  exostosis  upon  the  out- 

for  the  passage    of    the  oblique      .  -,  iii  ni  •  i 

tendon  of  the  flexor  metatarsi,  Side   would  be  Called  a  spavm,  and 

immediately  under  which  the  that  it  is  COmmonly  the  rCSult  of 
spavin  is  situated.  .    .  ,,   i      ,     t    i 

injury;  but  I  have  a  specimen  m 
my  possession,  presented  by  Mr.  Stevenson  of  Newcastle,  with 
a  spavin  in  this  unusual  position,  originating  from  no  apparent 
cause,  and  which  produced  an  incurable  lameness. 

Spavin  arises  from  causes  that  are  hereditary  or   constitu- 
tional and  local. 


DISEASES  OF  THE  HOCK.  303 

The  hereditary  predisposition  to  bone-spavin  is  beyond  doubt, 
all  writers  of  authority  being  agreed  upon  the  point,  which  is 
also  well  known  to  breeders  of  horses.  This  hereditary  pre- 
disposition is  not  always  due  to  peculiarity  of  conformation, 
as  many  breeds  or  families  of  horses  with  well-formed  hocks 
often  become  unsound  from  this  cause.  Peculiarity  of  confor- 
mation is  nevertheless  not  only  hereditary,  but  is  of  itself  a  pre- 
disposing cause  of  spavin. 

Percivall  says — "  I  am  very  much  disposed  to  beKeve  in  the 
existence  in  the  system  of  what  I  would  call  an  ossific  diathesis. 
I  have  most  assuredly  seen  unbroke  colts  so  prone  in  their 
economy  to  the  production  of  bone,  that,  without  any  assignable 
outward  cause — without  recognisable  injury  of  any  kind — they 
have  at  a  very  early  age  exhibited  ring-bones,  and  splints,  and 
spavins.  There  might  have  been  something  peculiar  in  the 
construction  of  their  limbs  to  account  for  this ;  at  the  same 
time  there  appeared  a  more  than  ordinary  propensity  in  their 
vascular  system  to  osseous  effusion.  Growing  young  horses — 
and  particularly  such  as  are  what  is  called  "  overgrown '' 
— may  be  said  to  be  predisposed  to  spavin,  simply  from  the 
circumstance  of  the  weakness  manifest  in  their  hocks,  as  well  as 
other  joints.  When  horses  whose  frames  have  outgrown  their 
strength,  wdth  their  long  and  tender  limbs,  come  to  be  broke — 
to  have  weight  placed  upon  their  backs  at  a  time  when  the 
weight  of  their  own  bodies  is  as  much  as  they  are  able  to  bear 
— then  it  is  that  the  joints  in  an  especial  degree  are  likely  to 
suffer,  and  wind-gall  and  spavin  to  be  the  result.  Indeed,  under 
such  circumstances,  spavin,  like  splint  and  other  transformations 
of  soft  and  elastic  tissue  into  bone,  may  be  regarded  as  nature's 
means  of  fortification  against  more  serious  failures." 

These  remarks  of  Percivall  are  based  upon  correct  observa- 
tions, and  one  cannot  help  admiring  the  way  in  which  they 
are  put  before  the  reader.  There  is  not  one  point  that  I  can 
dispute,  unless,  indeed,  the  term  osseous  effusion,  which  may 
not  now  be  looked  upon  as  being  consistent  with  correct  patho- 
logical knowledge. 

The  local  or  exciting  causes  of  spavin  are  sprains  of  the  liga- 
ments, more  particularly  the  inter-osseous,  and  concussion  of  the 
bones.  The  old  writers  ascribed  spavins  to  blows ;  so  unlikely, 
however,  is  the  seat  of  them  to  receive  a  blow,  that  there  need 


o 


04  PARTICULAR  LAMENESSES. 


"be  no  hesitation  in  declaring  such  an  assertion  to  have  been 
made  without  foundation.  Advantage  has  nevertheless  been 
taken  of  it,  and  one  often  hears  sellers  of  horses  declaring  most 
solemnly  that  a  very  prominent  spavin  is  nothing  but  the 
result  of  a  kick  inflicted  before  their  own  eyes,  and  that  it  will 
go  away  in  a  few  days.  But  a  blow  sufficiently  heavy  to  cause 
such  a  swelling  leaves  a  mark ;  and,  "  not  to  be  done,"  these 
gentry  often  make  a  small  wound  on  the  skin  of  the  enlarge- 
ment. This  is  hardly  credible,  but  I  speak  from  actual  experi- 
ence and  knowledge  of  facts  that  have  come  "under  my  own 
observation.  Further,  I  have  heard  such  men  confess  that 
such  wounds  were  made  for  the  purpose  of  accounting  for  a 
lameness.  The  young  practitioner  must  not  be  misled  by  such 
tricks. 

One  fertile  source  of  spavin  is  the  alteration  of  the  direction 
of  the  leg,  brought  about  by  the  use  of  high-calkined  shoes. 
These  high  heels  alter  the  relative  position  of  the  limb,  from 
the  hip  downwards,  and  are  a  cause  of  shocks  of  concussion, 
which  are  felt  every  time  the  horse  puts  his  foot  to  the  ground 
during  action. 

The  form  of  Hock  most  susceptible  to  Spaviii. — Upon  this 
point  there  is  much  difference  of  opinion  amongst  veterinary 
writers ;  some  maintaining  that  short-pointed,  compact  hocks 
are  generally  spavined ;  others  think  sickle  or  cow-hocks,  and 
hocks  "  tied  in "  below ;  whilst  other  writers — more  especially 
the  advocates  of  the  compression  theory — are  of  opinion  that 
hocks  with  well-developed  calces  are  most  prone  to  become 
spavined.  These  latter  base  their  argument  upon  the  assump- 
tion that  the  point  of  the  hock  is  the  lever  of  the  extremity, 
and  that  the  parts  in  front  are  liable  to  compression ;  the  ex- 
tent of  such  compression  depending  on  the  length  of  the  lever. 
This  theory  is  self-apparently  fallacious,  as  the  lever  here  men- 
tioned acts  in  a  direction  contrary  to  that  which  would  cause 
compression. 

Notwithstanding  all  these  differences,  I  do  not  think  that 
there  is  any  kind  of  hock  that  can  be  said  to  be  exempt  from 
spavin,  provided  a  sufficient  cause  has  been  applied.  Cavalry 
horses,  when  the  drill  and  manege  exercises  were  more  violent 
than  tliey  are  at  present,  suffered  from  spavin  to  a  very  great 
extent.     "  Since,  however,  the  pace  has  become  moderate,  and 


DISEASES  OF  THE  HOCK. 


305 


the  halts  less  abrupt,  and  more  time  has  been  given  to  the 
cavalry  recruit  horse  for  the  evolution  of  his  natural  powers, 
the  disease  has  much  abated  in  prevalence." — (Percivall.) 

The  hock  described  as  "  tied  in  below "  is  that  form  where 
the  head  of  the  metatarsal  and  cuneiform  bones  are  small  com- 
jmred  with  the  bones  above.  The  cuneiform  and  metatarsal 
bones  are  receivers  of  weight  and  distributors  of  concussion ; 
their  capability  to  the  performance  of  those  functions  depends 
upon  their  size  and  development,  and  upon  the  breadth  of  sur- 
face they  present.  When  not  well  developed,  one  cannot  fail 
to  see  the  applicability  of  the  argument  that  they  are  predis- 
posed to  spavin,  and  as  a  rule  practice  proves  its  correctness ; 
but  there  are  many  exceptions,  and  one  often  sees  a  badly- 
formed  hock  remaining  sound  under  very  severe  tests. 

The  theory  of  Goodsir,  that  the  motion  of  the  true  hock- 
joint  is  like  a  screw,  is  well  Avorthy  of  consideration.  I  have, 
by  the  kindness  of  Professor  Turner,  obtained  the  loan  of  a 
cast  of  several  astrai^ali  united  to^^ether,  illustrative  of  the 
screw-like  direction  of  its  articulating  surface.  The  cast  was 
prepared  by  Mr.  Stirling,  the  curator  of  the  Edinburgh  Univer- 
sity Anatomical  Museum,  under  Professor  Goodsir'^s  immediate 
superintendence.  Being  the  result  of  the  observations  of  ono 
to  whom  the  Edinburgh  Veterinary  College  is  so  especially 
indebted,  it  cannot  fail  to  be  interesting. 


Fig.  51. — Astragali  united  to  show  the  screw  lines. 

By  carefully  examining  the  oblique  pulley-like  prominences, 
and  the  deep  groove  between  them,  on  the  superior  articulating 

X 


306  PARTICULAR  LAMENESSES. 

surface  of  an  astragalus,  the  observer  will  see  that  the  screw- 
like motion  is  subject  to  three  deviations.  First,  the  direction 
is  from  within  outwards  for  a  short  distance ;  then  it  seems  to 
run  perpendicularly ;  and,  finally,  the  lines  of  the  prominences 
are  seen  to  curve  towards  the  inner  side  and  on  to  the  inner 
third  of  the  cuneiform  magnum,  the  inner  prominence  of  the 
astragalus  terminating  abruptly,  and  leaving  a  hollow  space 
for  the  end  of  the  internal  prominence  (malleolus)  of  the  tibia. 
This  abrupt  termination  allows  the  final  act  of  flexion  in  the 
hock  to  be  performed  with  gTeat  velocity  and  suddenness.  One 
can  see  it  in  a  fast-going,  well-actioned  horse,  giving  sharpness 
and  grace  to  the  hock  action ;  but  whilst  it  allows  this  advantage, 
it  is  apt  to  be  a  source  of  mischief,  by  acting  directly  upon  the 
cuneiform  bones,  and  proving  a  source  of  concussion  to  them 
during  sharp  flexion.  This,  in  addition  to  the  concussion 
received  when  the  foot  comes  to  the  ground,  is  sufficient  to 
cause  inflammation  of  the  cuneiform  bones,  and  spavin. 

The  relative  obliquity  and  position  of  the  true  hock-joint, 
and  the  direction  of  its  motion  with  relation  to  the  production 
of  disease  of  the  lower  rows  of  bones,  are  subjects  well  worthy 
of  consideration,  and  open  a  fair  field  of  investigation  to  the 
veterinary  pathologist.  Pertinent  to  this  matter,  one  might 
naturally  ask,  Why  should  there  be  three  rudimentary  screws 
on  the  surface  of  the  astragalus  ?  The  explanation  is  based 
upon  the  fact  that  the  animal  must  be  able  to  lock  the  joint 
whilst  asleep  on  its  legs.  It  has  been  already  explained  that 
the  ligaments  and  the  tendinous  structure  of  the  muscles  of  the 
fore  arm  enable  the  fore  legs  to  remain  unbent  during  sleep. 
In  addition  to  tendinous  muscles  and  ligaments,  we  find  that 
the  posterior  extremities  (and  they  are  much  more  liable  to 
bend  under  the  animal's  weight,  as  may  be  witnessed  in  cases 
of  debility)  are  furnished  with  a  lock  in  the  true  hock-joint, — 
the  lock  being  the  deviation  of  the  screw  lines,  which  enables 
it  to  sleep  without  falling.  The  remarkable  manner  in  which 
flexion  of  the  true  hock-joint  is  performed  has  been  remarked 
by  Dr.  Graves  of  Dublin;  and  a  valuable  paper  by  Professor 
Dick  on  the  subject,  and  on  the  conformation  of  the  knee  and 
elbow  joints,  may  be  consulted  with  advantage.  It  is  printed 
along  with  his  memoirs. 

Amongst  the   variety   of  hocks   that   a   veterinary   surgeon 


DISEASES  OF  THE  HOCK.  307 

examines,  what  is  termed  a  "  coarse  hock,"  is  often  seen.  By 
this  term  is  meant  a  hock  with  well-developed  cuneiform  bones, 
giving  a  prominence  to  the  articulation,  very  much  resembling 
spavin ;  and  it  is  generally  borne  out  by  experience  that  such 
hocks  are  superior  to  those  of  a  finer  description,  standing  more 
wear  and  tear,  and  remaining  sound.  It  was  laid  down  as  a 
rule  by  the  late  Mr.  Barlow,  that  if  both  hocks  were  alike,  and 
the  action  good,  joints  coarsely  formed  should  not  be  condemned 
as  unsound,  more  particularly  if  the  enlargements  were  situated 
towards  their  posterior  aspect. 

I  have  made  many  dissections,  and  found  that  such  enlarge- 
ments were  often  due  to  disease,  even  in  horses  that  were  never 
known  to  be  lame.  Why  the  presence  of  such  deposits  did 
not  cause  lameness  will  be  better  understood  after  the  pathology 
of  spavin  has  been  discussed. 

Many  horses  are  foaled  with  irregular  hocks,  very  often  with 
one  hock  larger  than  the  other ;  and  such  are  apt  to  be  con- 
demned as  being  diseased  and  unsound.  Experience,  however, 
proves  that  a  young  horse,  rough  in  his  hocks,  if  put  to  work 
before  he  has  arrived  at  his  full  growth,  is  apt  to  fall  lame ; 
and  that  the  same  animal,  if  allowed  to  rest  until  he  is  old 
enough  for  work,  will  remain  sound  for  many  years,  although 
a  marked  disparity  may  exist  between  the  two  hocks.  Again,  a 
horse  at  four  years  old  will  look  coarse  in  the  hocks,  or  even 
spavined ;  but  when  he  is  six,  the  same  horse  will  appear  quite 
fine  and  sound,  provided  he  has  been  properly  cared  for. 

It  is  almost  impossible  to  lay  down  a  rule  as  to  what  con- 
stitutes an  unsoundness,  provided  the  animal  goes  sound,  and 
has  pretty  good  hock  action.  Spavins  in  front  of  the  hock  are 
generally  condemned,  and  justly  so  ;  but  even  when  so  situated, 
one  very  often  finds  they  cause  oqo  lameness,  at  least  during 
the  middle  period  of  the  animal's  life. 

The  lameness  of  bone-spavin  is,  as  a  rule,  removeable  in  the 
young  and  middle-aged,  but  incurable  (with  few  exceptions)  in 
horses  past  their  prime.  In  the  two  former  it  is  due  to  an 
inflammation,  which  of  itself  brings  about  the  reparative  pro- 
cess ;  in  the  latter,  to  a  degenerative  disease  in  the  bones,  partaking 
of  the  nature  of  fragilitus  ossium,  unaccompanied  by  a  true 
process  of  repair. 

Fathology. — Bone-spavin  consists  of  inflammation  excited  in 


308 


PARTICULAR  LAMENESSES. 


the  cuneiform  bones,  or  in  the  cuneiforms  and  large  metatarsal 
and  sometimes  the  inner  small  metatarsal,   either  from  con- 


FiG.  52. 


Fig.  53. 

Fig.  52  represents  the  inferior  surface  of  cuneiform  medium  and 
parvum  and  os  cuboides  in  a  state  of  ulceration,  with  their  canceUi 
exposed,  a,  6,  Cuneiform  medium  ;  c,  Os  cuboides  :  d,  Cuneiform 
parvum.  ' 

Fig.  53.— Articular  heads  of  the  three  metatarsal  bones  from  same 
nock,  a,  Large  ;  h,  mner  smaU  ;  c,  outer  smaU,  showing  caries  cor- 
respondmg  to  that  found  in  the  opposing  bones. 


DISEASES  OF  THE  HOCK.  309 

cussion  applied  to  the  bones  themselves,  or  extension  of  inflam- 
mation of  the  inter-osseous  ligaments,  which  are,  in  every  case 
that  I  have  examined,  implicated  in  the  morbid  process. 

The  inflammation  of  the  bones  (ostitis)  originates  in  the 
cancellated  structure  of  their  interior;  an  exudation  is  gradu- 
ally thrown  out  between  them  and  their  cartilage,  pervert- 
ing the  nutrition  of  the  latter,  whereby  it  ulcerates  and  is 
removed,  leaving  the  exposed  surfaces  of  the  bones  in  contact 
with  each  other,  and  their  cancellated  structures  in  apposition ; 
thus  enabling  their  vessels  to  communicate  with  each  other,  as 
already  described  in  the  chapter  on  Anchylosis.  Concomi- 
tant with  the  destructive  process  going  on  in  the  interior  of  the 
bones,  an  exudate  is  formed  upon  their  periosteal  surface,  ex- 
tending from  one  diseased  bone  to  another,  binding  them 
together  by  a  band  of  lymph — ultimately  converted  into  bone — 
which  locks  them  firmly  together,  and  prevents  further  motion. 
In  old  horses  the  process  of  anchylosis  is  limited  to  the  periosteal 
surfaces,  whilst  the  destructive  action  still  proceeds  upon  the 
articular  ones ;  whereas  in  the  young  or  middle-aged  lymph  is 
thrown  out  between  the  ulcerated  surfaces  of  the  bones,  which 
is  organized  into  true  osseous  matter,  making  the  process  of 
anchylosis  complete  at  all  points.  The  incurability  of  the 
lameness  in  the  old  must  be  ascribed  to  this  non-termination 
of  the  process ;  for  however  extensive  the  deposition  of  bony 
matter  is  upon  the  external  surface  of  the  bones,  if  their  exposed 
cancelli  come  into  contact  with  each  other,  the  lameness  will 
most  assuredly  remain. 

We  may  now  understand  why  the  external  deposit  is  not 
the  cause,  but  the  result  of  the  disease,  and  why  its  presence 
is  not  always  accompanied  by  lameness.  So  long  as  the 
carious  surfaces  of  the  bones  are  unrepaired,  so  long  will  the 
lameness  remain;  but  when  the  bones  are  locked  together — 
are,  in  fact,  converted  into  one  bone,  performing  the  functions  of 
one  bone — the  lameness  disappears,  and  the  reparative  material 
becomes  as  one  of  the  essential  structures  of  the  economy.  The 
destruction  of  the  slicrht  o-lidin^  motion  of  these  articulations  is 
of  but  little  consequence,  as  it  does  not  interfere  with  the  flexile 
action  of  the  hock. 

Eeasoning  upon  these  observations,  and  upon  the  well-known 
fact  that  an  old-standing  spavin  of  the  young  and  middle-aged 


SIO  PARTICULAR  LAMENESSES. 

horse  does  not  always  cause  lameness,  we  are  warranted  in 
endorsing  the  popular  and  common  conclusion,  that  an  old- 
standing  spavin  seldom  does  harm,  and  that  it  is  only  during 
its  formation  it  interferes  with  the  usefulness  of  the  animal. 

But  a  spavin,  to  terminate  so  favourably,  must  be  limited  in 
its  extent;  perfect  immunity  from  a  recurrence  of  lameness 
may  result  when  it  is  confined  to  the  cuneiforms  and  meta- 
tarsals ;  but  if  the  superior  surface  of  the  cuneiform  magnum 
and  the  lower  articulating  surface  of  the  astragalus  are  involved, 
in  addition  to  the  others,  I  do  not  think  that  perfect  restoration 
can  be  effected.  In  many  of  the  specimens  in  the  College 
Museum,  not  only  are  all  the  gliding  bones  involved,  but  also 
the  bones  of  the  true  hock-joint.  Such  changes  must  cause 
permanent  lameness. 

In  conclusion,  I  may  mention  that  a  practice  prevails  in 
some  parts  of  the  country  by  which  hocks  that  present  a  want 
of  S5niimetry  in  the  seat  of  spavin,  and  particularly  if  one  hock 
is  larger  than  its  fellow,  are  made  as  nearly  alike  as  possible. 
The  operation  is  called  causticking,  and  is  as  follows : — Upon 
the  coarse  hock  an  incision  is  made  a  short  distance  below  the 
spavin,  and  a  piece  of  caustic  inserted  subcutaneously  to  the 
lase  of  the  enlargement.  This  causes  inflammation  and  a  filling 
up  of  the  hollow  beneath  the  spavin ;  in  fact,  it  hides  the  latter 
by  elevating  the  former. 

Upon  the  ''  fine  "  hock  the  caustic  is  pushed  up  and  lodged 
in  the  spot  where  the  spavin  ought  to  he  !  This  makes  the  one 
hock  as  coarse  as  the  other ;  the  coarse  one  apparently  finer 
than  before  the  operation,  the  fine  one  coarser.  This  operation 
very  often  removes  the  lameness  of  spavin  by  exciting  the 
exudation  of  lymph,  and  hastening  the  process  of  anchylosis 
between  the  cuneiform  bones. 


DISEASES  OF  THE  LIGAMENTOUS  AND  TENDINOUS  STRUCTURES  OF 

THE  HOCK. 

TJiorough-pin  is  a  bursal  enlargement  situated  on  the  inferior 
lateral  aspect  of  the  thigh  and  upper  and  posterior  part  of  the 
hock,  arising  from  disease  of  the  tendon  of  the  flexor  pedis  per- 
forans  muscle,  which  is  enclosed  in  a  synovial  sheath,  on  the 
inner  side  of  the  os  calcis,  or  from  dropsy  of  the  sheath,  without 


DISEASES  OF  THE  HOCK. 


311 


disease  of  the  tendon.  The  fluid  which  fills  it  may,  by  pressure, 
be  forced  from  one  side  to  the  other ;  hence  the  term  thorough- 
pin,  or  running  through  from  side  to  side.  This  may  be 
described  as  true  thorough-pin,  in  contradistinction  to  that 
associated  with  very  large  bog-spavins. 

A  thorough-pin,  however  large,  does  not  cause  bog-spavin,  as 
there  is  no  real  channel  of  communication  between  the  true  hock- 
joint  and  the  bursa  of  the  perforans  tendon ;  but  the  capsule  of 
the  joint  swells  upwards  and  backwards,  bulges  into  the  bursa 
of  the  tendon,  and  a  large  bog-spavin  may  thus  cause  the  dis- 
tension of  the  bursa,  and  the  appearance  of  thorough-pin. 

Tlwrougli-pins  are  generally  found  in  short,  fleshy,  upright 
hocks,  where  the  os  calcis  is  short  and  ill  developed.  We  can 
account  for  such  hocks  being  subject  to  them  by  the  knowledge 
that  the  lever  of  the  limb  being  a  short  one,  more  strain  is 
thrown  upon  the  flexor  tendons,  the  flexors  of  the  foot  being 
extensors  of  the  hock. 

•  Eailway  shunt  horses  are  very  liable  to  fall  unsound  from 
thorough-pin,  in  consequence  of  the  very  heavy  truck  loads  they 
have  to  start. 

In  the  treatment  of  thorough-pins  and  bog-spavins,  rest,  the 
high-heeled  shoe,  and  pressure  by  a  spring  truss,  are  the  most 
effective  appliances.    Some  recommend  puncturing  the  sac.    This 


Fig.  54. — Spring  truss  for  thorough-pin  and  bog-spavin,  designed 
by  Mr.  Broad,  Bath. 

I  have  performed  in  some  cases  with  satisfactory  results ;  but  as 
a  rule  I  think  the  operation  should  be  avoided.  The  method  of 
puncturing  the  bursa  subcutaneousl}^,  by  making  a  very  small 
incision  and  drawing  out  the  fluid  with  a  syphon  is  useless,  the 
sac  becoming  quite  full  again  in  the  course  of  a  few  hours.  If  a 
puncture  is  to  be  made  at  all,  it  should  be  at  the  bottom  of  the 


312  PARTICULAR  LAMENESSES. 

swelling,  sufficiently  large  to  allow  the  complete  removal  of 
the  fluid ;  and  it  should  remain  open  for  some  days.  No  fear 
need  be  entertained,  although  signs  of  pain  and  fever  may  ensue, 
as  an  open  bursa  is  not  so  serious  as  an  open  joint. 

After  the  sac  is  emptied,  a  weak  solution  of  sulphate  of  zinc 
or  dilute  tincture  of  iodine  may  be  injected ;  the  walls  of  the 
sac  brought  into  apposition  by  firm  but  careful  bandaging ;  a 
flannel  bandage,  owing  to  its  elasticity,  being  the  best  of  all. 


CAPPED  HOCK. 

The  gastrocnemius  internus  muscle  terminates  about  half-w^ay 
down  the  tibia  in  a  strong  tendon ;  it  is  at  first  within  the  tendon 
of  the  gastrocnemius  externus ;  winds  round  its  side ;  then 
surmounts  it,  and,  on  reaching  the  point  of  the  os  calcis,  forms  a 
cap,  giving  off  slips  of  insertion  from  each  side  to  the  bone.  A 
large  synovial  bursa  exists  between  the  tendons  here,  and  is 
one  of  the  seats  of  capped  hock. 

There  are  two  forms  of  capped  hock — the  synovial  and  the 
serous. 

Synovial  Capped  Hock  appears  as  a  tense  fluctuating  swelling, 
situated  upon  both  sides  of  the  point  of  the  hock ;  the  tendon, 
being  posterior  to  the  bursa,  prevents  the  swelling  of  the  internus 
from  bulging  backwards.  It  is  an  unsoundness,  causing  lame- 
ness, and  sometimes  the  formation  of  abscesses  from  caries  or 
necrosis  of  the  summit  of  the  os  calcis. — (See  Photo-lithograph, 
Plate  I.,  Fig.  3.) 

The  Serous  Capped  Hock,  a  serous  abscess  caused  by  pressure 
or  violence,  is  situated  in  the  areolar  tissue,  between  the  tendon 
of  the  gastrocnemius  internus  and  skin. 

It  is  not  an  unsoundness,  if  not  causing  lameness,  and  arises 
generally  from  the  horse  striking  the  point  of  his  hock  against 
some  hard  substance.  It  very  often  indicates  a  kicker,  either  in 
harness  or  in  the  stable,  is  unsightly  when  large,  and  depreciates 
the  value  of  the  animal. 

Displacement  of  Tendon  of  Gastrocnemius  Internus. — Professor 
Dick  used  to  relate  that  he  had  met  with  cases  of  what  he  called 
dislocation  of  the  tendon  of  the  gastrocnemius  internus,  and  that 
the  tendon  had  been  torn  from  its  attachment  to  the  os  calcis. 
He  said  it  always  fell  to  the  outside,  thereby  not  untwisting  itself 


CAPPED  HOCK.  313 

from  the  externus  ;  but  that  it  was  quite  possible  for  it  to  fall  to 
the  inside.  He  said  that  a  groove  was  formed  for  it  on  the  side 
of  the  bone,  and  that  the  patient  regained  his  soundness. 

This  is  a  rare  form  of  injury.  I  have  recently  seen  two  cases 
of  it,  arising  from  kicking,  the  animals  striking  the  points  of  the 
calces  violently,  causing  inflammation  of  the  bursse,  or  synovial 
capioed  liock.  Although  in  one  case  the  displacement  was  evi- 
dent very  shortly  after  the  infliction  of  the  injury,  yet  in 
neither  instance  was  there  any  tearing  of  the  tendons  from 
their  attachments,  but  simply  an  elongation  and  loss  of  co- 
hesion, from  inflammation  in  the  ligamentous  bands  which  bind 
them  to  the  os  calcis,  as  well  as  from  pressure  of  the  increased 
synovial  secretion,  allowing  the  tendons  to  slip  outwards  when- 
ever the  foot  was  elevated. 

The  treatment  consists  in  throwing  the  part  into  a  state  of 
repose  by  the  application  of  the  high-heeled  shoe,  cold  water  to 
the  seat  of  injury,  and  when  the  inflammation  is  reduced,  blister 
or  firing  by  pyro-puncture. 

The  tendo-achilles  may  be  torn  from  its  attachment  to  the  os 
calcis ;  as  a  rule  this  is  accompanied  by  fracture  or  detachment 
of  the  epiphysis,  and  occurs  in  young  animals  before  the  ex- 
tremity has  become  permanently  united  to  the  body  of  the  bone. 

INJURIES  TO  GASTROCNEMII  MUSCLES. 

Injuries  to  the  gastrocnemii  muscles  or  to  their  tendons  are 
known  by  the  animal  presenting  symptoms  the  reverse  of  those 
manifested  when  the  flexor  metatarsi  is  injured,  as  in  the  case 
illustrated  at  page  297.  In  injuries  to  the  gastrocnemii,  the 
foot  is  elevated  from  the  ground,  as  in  stringhalt,  the  leg  being 
suddenly  brought  upward  and  I'orward  at  each  step.  When 
the  animal  is  standing  still  there  will  bo  knuckling  over  at  the 
fetlock-joint,  owing  to  the  loss  of  power  in  the  gastrocnemii. 
which  act  during  repose  as  extensors  of  the  hock.  Division  of 
the  tendo-achilles  is  called  "  ham-strung ;  and  when  such  an 
injury  is  inflicted,  the  fetlock  is  brought  to  the  ground,  and 
the  limb  is  powerless.  I  have,  however,  seen  such  cases  do  well, 
when  the  leg  has  been  fastened  on  to  a  long  stiff  splint,  extend- 
ing from  the  foot  to  the  stifle  in  front  of  the  limb,  and  kept  in 
this  position  by  proper  bandages. 


314  PAETICULAR  LAMENESSES. 


CUEB. 

This  is  an  injury,  sprain,  to  tlie  calcaneo-ciiLoid  ligament, 
and  not  to  the  cellular  tissue,  as  described  by  Percivall  and 
others ;  nor  is  it  a  sprain  of  the  broad  annular  ligament  which 
passes  over  and  binds  down  the  tendons  in  their  passage  down 
the  back  of  the  hock,  although  the  annular  ligament  as  well 
as  the  tendons  may  suffer  when  the  injury  is  very  violent.  Such 
cases  are  commonly  called  "  sprung  hock,"  and  are  associated 
with  great  lameness. 

The  original  seat  of  the  injury  in  curb  may  be  at  the  point  of 
attachment  of  the  ligament  to  the  cuboid,  or  at  its  ultimate 
termination  on  the  head  of  the  external  small  metatarsal  bone, 
or  its  attachment  to  the  posterior  aspect  of  the  os  calcis  may  be 
lacerated  to  a  considerable  extent. 

In  the  first  instance,  it  presents  itself  as  a  small  hard  nodule 
upon  the  lower  part  of  the  posterior  aspect  of  the  hock;  so 
small  and  so  hard  that  it  is  sometimes  impossible  to  say  whether 
it  is  the  injured  ligament  or  the  bones  themselves.  In  the 
second,  it  can  easily  be  recognised  as  a  protuberance  upon  the 
back  of  the  hock,  from  four  to  five  inches  below  the  point  of 
the  OS  calcis. 

Curb  is  apt  to  cause  lameness  in  young  horses,  or,  when  of 
fresh  origin,  in  horses  of  any  age.  Curbs  of  long  standing, 
being  merely  the  remains  of  former  disease,  very  seldom  cause 
lameness,  and  are  very  often  considered  by  men  of  experience 
not  to  be  an  unsoundness. 

Curby  hocks  are  over-bent  or  sickle-shaped,  and  if  associ- 
ated with  long  calces,  are  almost  sure  to  become  the  seat  of 
true  curb. 

From  what  has  already  been  said  about  the  leverage  power 
of  a  long  OS  calcis,  it  will  be  understood  that  the  ligaments 
which  bind  it  down  are  much  more  liable  to  sprain  when 
it  is  long  than  when  it  is  short.  The  form  of  hock  the 
reverse  of  that  liable  to  thorough-pin  is  the  one  predisposed 
to  curb. 

An  aged  horse,  when  suffering  from  curb  lameness,  is  gene- 
rally sound  again  in  a  few  weeks;  but  if  the  patient  be  a 
young  horse  whose  bones  are  not  fully  consolidated,  it  takes  a 
much  longer  time  before  the  parts  are  restored ;  and  if  such  an 


CURB.  315 

one  be  put  to  work  before  they  are  tliorouglily  repaired  and 
strengthened,  lameness  will  in  all  probability  recur.  Curb 
lameness  does  not  depend  upon  the  magnitude  of  the  enlarge- 
ment, some  very  large  curbs  causing  little  or  no  lameness,  and 
some  small  ones  proving  a  source  of  very  severe  lameness. 
Curb  lameness  is  characterised  by  difficulty  in  extending  the 
hock,  and  in  some  very  severe  cases  by  that  condition  of  the 
tendo-achilles  already  described,  the  limb  being  elevated,  and 
the  tendo-achilles  remaining  in  a  state  of  relaxation.  This  arises 
from  the  animal  avoiding  to  exercise  muscular  force  on  the  os 
calcis,  and  endeavouring  to  mitigate  pain. 

Horses  liable  to  curb  should  be  shod  with  a  shoe  high  in 
the  heel,  and  care  should  be  taken  that  it  be  not  allowed  to 
wear  too  low,  else  lameness  is  almost  sure  to  recur.  Cart-horses 
with  curbs  should  not  be  shod  with  high  toe-pieces,  or  the 
increased  resistance  to  the  action  of  the  muscles  upon  the  calcis 
will  cause  lameness. 

Whether  a  curb  be  an  unsoundness  or  not  must  be  left 
to  the  practitioner;  legally  it  is  so,  but  in  reality  an  old 
curb,  unaccompanied  by  heat  of  the  part,  and  causing  no 
lameness,  does  not  generally  interfere  with  the  usefulness  of 
the  animal. 

In  some  parts  of  the  country,  young  animals  are  fired  to 
strengthen  the  hocks,  and  prevent  curb  and  spavin.  Such  cases, 
when  they  come  before  the  veterinary  surgeon  for  examination 
as  to  soundness,  have  a  suspicious  look  about  them,  but  if  the 
hocks  are  good  and  the  action  sound,  the  marks  of  the  cautery 
are  no  indication  of  unsoundness. 

This  practice  of  tiring  to  prevent  disease  is  most  cruel  and 
useless.  It  cannot  be  too  strongly  condemned ;  and  Martin's  Act 
should  be  applied  to  every  one  guilty  of  such  barbarity. 

Treatment  of  Curb. — Eest,  a  high-heeled  shoe,  reduction  of 
the  inflammation,  and  afterwards  removal  of  the  thickening 
by  means  of  iodine  or  its  salts.  If  lameness  is  persistent, 
firing. 

The  tendon  of  the  flexor  pedis  perforans  is  liable  to  injury 
as  it  passes  through  the  tarsal  groove,  succeeded  by  great  lame- 
ness, distension  of  tjie  bursa,  the  swelling  prominent  both  below 
and  above  the  hock  on  its  postero-internal  aspect.  The  tendon 
is  bound  down  at  the  tarsal  groove  by  the  posterior  annular 


316  PAETICULAR  LAMENESSES. 

ligament,  thus  preventing  the  swelling  from  appearing  except 
above  and  below. 

The  superior  tarsal  ligaments  correspond  to  the  radials ; 
the  metatarsals  to  the  metacarpals  in  the  fore  extremity.  Both 
are  liable  to  sprain,  the  latter  much  oftener  than  the  former, 
characterised  by  lameness,  swelling,  and  other  signs  ah^eady 
described. 


CHAPTER  XVII. 

TREATMENT   OF  LAMENESS. 

REST — POSITION    OF   THE   LIMB — REMOVAL    OF    SHOES — HIGH-HEELED 

SHOE THIN-HEELED     SHOE HOT     AND     COLD     FOMENTATIONS 

LOCAL      BLEEDING — PURGATIVES — COUNTER-IRRITANTS — BLIS- 
TERS  SETONS ACTUAL  CAUTERY THEORY  OF  THEIR  ACTION. 

Before  describing  the  diseases  of  the  feet,  which  are  so 
numerous  and  important  as  to  require  special  consideration,  I 
will  endeavour  to  give  a  brief  description  of  the  treatment  of 
lameness.  The  first  and  most  important  necessity  in  this  matter 
is  to  form  a  correct  diagnosis ;  without  this  all  is  hap-hazard, 
and  calculated  to  do  much  harm.  The  next  step  is  the  removal 
of  the  cause,  if  that  be  possible,  and  of  every  circumstance  cal- 
culated to  aggravate  the  effect.  After  these  things  are  attended 
to,  the  position  of  the  limb  and  foot  demand  attention,  in  order 
that  the  patient's  efforts  to  remove  pressure  and  tension  from 
the  seat  of  pain  may  be  assisted.  If  a  lame  horse  stands  with 
the  foot  of  the  lame  limb  flat  upon  the  ground,  that  is  to  say, 
touches  the  ground  with  both  heel  and  toe,  and  if  the  feet  are 
strong  and  good,  I  am  of  opinion  that  all  his  shoes  should  be 
removed,  in  order  that  he  may  stand  upon  his  feet,  and  be 
able  to  poise  his  body  in  nature's-way.  But  if  his  feet  are  bad 
and  weak,  they  must  be  protected  by  light  plain  shoes.  Trifling 
cases  of  lameness,  where  in  all  probability  recovery  will  take 
place  in  a  few  days,  are  exceptions  to  this  method ;  but  in  all 
instances  where  it  is  likely  the  patient  will  require  a  period  of 
yest,  the  plan  is  to  be  highly  commended. 

If,  however,  the  horse  is  inclined  to  elevate  the  heel,  to  stand 
on  his  toe — the  posture  indicating  that  parts  are  thus  relieved 
and  pain  diminished — he  must  be  encouraged  in  this  by  having 
a  patten  or  high-heeled  shoe  applied.     This  will,  in  many  in- 


318  TREATMENT  OF  LAMENESS. 

stances,  afford  much  immediate  relief;  but  if,  on  the  contrary, 
he  is  inclined  to  throw  his  weight  upon  the  heels,  a  thin-heeled 
shoe  should  be  used.  The  shoe  recommended  by  Mr.  Broad,  of 
Bath,  for  laminitis,  which  will  be  described  hereafter,  answers 
the  purpose  in  all  such  cases,  except  when  the  posterior  part  of 
the  limb  and  heel  descend  from  ruptured  sesamoidean  hgament, 
as  already  mentioned. 

Such,  then,  are  the  first  circumstances  to  which  the  practi- 
tioner must  attend,  in  order  to  place  the  injured  structures  in 
a  state  of  repose. 

When  the  parts  are  put  in  as  complete  a  state  of  rest 
as  possible,  the  effects  of  the  primary  lesion  will  command 
attention.  These  are  inflammation,  with  pain,  and  perhaps 
swelling. 

The  inflammation  is  the  result  of  the  injury,  and,  except  in 
cases  where  the  textures  involved  have  become  torn,  lacerated, 
or  crushed,  it  is  the  only  morbid  condition  present  in  the  early 
period  of  the  lameness. 

It  is  of  the  utmost  importance  to  bear  this  in  mind,  as  by 
proper  attention  to  the  animal,  alterations  of  structure  may  be 
prevented  ;  whereas  if  he  be  now  neglected,  worked  from  day  to 
day,  and  otherwise  improperly  treated,  organic  changes  ensue, 
rendering  the  lameness  incurable,  or  curable  only  by  a  length- 
ened process  of  repair. 

For  the  reduction  of  the  inflammation,  hot  or  cold  applications 
to  the  part  are  useful.  I  prefer  warm,  considering  that  they  are 
more  soothing  in  the  early  stages  than  cold.  Notwithstanding 
my  own  preference  to  w^arm  applications  in  the  earlier  stages,  I 
must  in  justice  state  that  the  general  belief  is  in  the  efficacy  of 
cold  at  first,  warm  afterwards ;  and  that  this  belief  is  based  upon 
the  ground  that  cold  moderates  excessive  vascular  action,  by 
causing  vital  contraction  of  the  vessels,  and  hence  its  applica- 
tion immediately  after  the  receipt  of  blows  or  injuries  restrains 
inflammation ;  and  that  heat  acts  by  soothing  the  nervous  system 
of  the  part,  relaxes  the  vessels  and  tissues,  so  that  the  vessels 
relieve  themselves  by  effusion  ;  in  other  words,  heat  promotes 
the  secretory  inflammation. 

There  is,  however,  no  rule  to  guide  the  practitioner  in  pre- 
scribing either  hot  or  cold,  and  the  choice  is  very  often  a  matter 
of  experience. 


COUNTER-IRRITANTS.  319 

In  all  painful  affections,  warm  fomentations  or  poultices  must, 
as  a  rule,  be  prescribed ;  in  the  course  of  some  days,  however,  if 
the  pain  is  subsiding,  and  the  parts  seemingly  relaxed,  much 
benefit  will  be  obtained  by  making  a  change  to  cold,  mild  astrin- 
gents, and  bandages,  to  promote  absorption  of  the  exudate. 

The  congested  ca^^illaries  may  be  relieved  by  local  bleeding, 
but  the  parts  upon  which  such  an  operation  is  performed  are 
very  few,  except  about  the  coronet  or  the  foot.  An  incision 
into  the  coronary  plexus  will  reach  the  vessels  at  once ;  the 
utility  of  this  is,  however,  very  doubtful,  except  in  rare  cases. 
Bleeding  at  the  toe,  although  much  practised  by  some,  is  not  to 
be  commended. 

Purgatives  are  very  useful  during  the  first  stages  of  lame- 
ness, reducing  the  inflammation ;  a  full  dose  of  aloes  may  be 
given  with  advantage,  the  diet  being  properly  regulated,  and 
restricted  to  bran-mashes,  a  little  hay,  and  the  water  to  be 
chilled. 

After  the  acute  signs  of  inflammation  have  subsided,  if  the 
lameness  still  remains,  the  application  of  the  so-called  counter- 
irritants  will  be  rendered  necessary. 

These  consist  of  rubefacients,  blisters,  setons,  and  the  actual 
cautery.  The  action  of  these  remedies  differs  only  in  degree, 
in  rapidity,  and  in  permanence,  not  in  the  nature  of  the  exuda- 
tion which  they  produce. 

The  theory  of  counter-irritation  is  one  of  great  obscurity.  It 
is  all  very  well  to  say  that  counter-irritants  act  by  causing 
metastasis,  or  a  translation  of  the  disease  from  one  part  to  an- 
other. I  need  scarcely  here  discuss  the  origin  of  the  idea  that 
it  is  based  upon  the  assumption  that  no  two  inflammations  can 
exist  in  the  system  at  the  same  time,  and  that  by  exciting  a 
manageable  superficial  inflammation  we  counteract  or  remove 
the  deep-seated  and  unmanageable  one.  This  theory  of  counter- 
ii'ritation  is  founded  upon  a  false  and  irrational  basis,  and  has 
been  the  means  of  destroying  the  lives  of  thousands  of  horses. 
Without  entering  into  any  speculative  discussion  upon  the 
question,  superficial  irritants  are  very  beneficial  in  all  cases  of 
chronic  lameness,  whether  it  be  caused  by  disease  in  bone,  car- 
tilage, ligament,  tendon,  or  any  other  structure;  and  they  are 
often  more  decidedly  beneficial  when  applied  to  the  diseased 
structure  itself  than  to  the  skin  covering  it.     For  example,  a 


320  TREATMENT  OF  LAMENESS. 

lameness  arises  from  bone-spavin ;  its  eradication  is  mucli  more 
certain  and  rapid  when  a  pointed  cautery  is  applied  to  the 
diseased  bones  than  when  the  hock  is  fired  in  the  ordinary  way. 
Again,  a  spavin  has  been  fired  and  blistered  repeatedly  without 
benefit ;  the  bones  are  "  punched  " — a  barbarous  operation,  and 
only  to  be  performed  in  extreme  cases — violent  inflammation 
is  excited  in  the  diseased  bones,  which  for  a  time  increases  the 
lameness ;  but  this  gradually  subsides,  and  the  original  lameness 
is  found  to  be  removed. 

How,  then,  are  we  to  account  for  such  results  ?  Certainly 
not  by  the  theory  of  metastasis.  Dr.  Bennett,  sceptical  as  he 
is  in  most  things,  seems  to  believe  in  the  doctrine  of  counter- 
irritation,  and  thus  expresses  himself: — "Artificial  irritations  of 
the  skin,  to  produce  internal  or  distant  effects,  are  caused  by 
what  are  denominated  counter-irritants,  including  stimulants, 
frictions,  hot  applications  to  parts,  sinapisms,  blisters,  moxas, 
cauteries,  &c.,  &c.  These  all  operate  through  the  nerves  by 
reflex  action ;  some,  like  warm  fomentations,  soothe  irritation ; 
others,  as  blisters,  create  it  locally,  but  remove  it  where  it  was 
primarily  seated.  How  this  is  accomplished  constitutes  one  of 
the  most  vexed  questions  in  therapeutics." — (Bennett's  Prin- 
ciples and  Practice  of  Medicine?) 

I  am  of  opinion  that  the  curative  action  of  external  irritants 
is  not  due  to  their  producing  metastasis  or  counter-irritation,  but 
that  they  excite  within  the  originally  diseased  structure  a  repara- 
tive inflammation,  partaking  in  its  nature  of  what  is  described 
by  Virchow  as  the  "  secretory  inflammation,"  which,  su2:)erseding 
the  original  diseased  process  (whether  that  be  inflammation  pure 
and  simple  or  its  effects,  ulceration,  caries,  or  the  formation  of 
a  low  form  of  fibrous  tissue),  excites  the  formation  of  reparative 
material,  by  which  breaches  are  united,  ulcers  healed,  and 
diseased  action  removed. 

To  illustrate  this  view,  I  will  bring  forward  two  familiar  ex- 
amples : — 1st.  The  healing  of  a  sinus  or  fistula,  after  the  applica- 
tion of  a  blister,  or  of  the  actual  cautery  to  the  skin  contiguous 
to  it ;  and  2d.  The  removal  of  phlebitis  by  a  blister. 

In  the  first  instance,  we  find  that  a  sinus  heals  after  a  blister 
or  cautery  by  the  formation  of  an  organizable  exudate,  which 
completely  fills  up  the  cavity  of  the  sinus ;  and,  in  the  second, 
we  find  that  a  blister  assists  in  the  obliteration  of  the  inflamed 


COUNTER-IRRITANTS.  321 

vein ;  not  by  removing  the  inflammation  from  it,  but  by  pro- 
moting the  formation  of  a  large  quantity  of  reparative  lymph, 
and  hastening  its  further  development  into  fibrous  tissue,  by 
which  the  vessel  is  transformed  at  the  inflamed  part  into  a 
fibrous  cord.  Now,  if  the  curative  action  were  due  to  the  re- 
moval of  inflammation,  we  should  find  that  in  the  first  case  the 
relief  would  be  only  of  a  temporary  nature ;  the  sinus  would  still 
remain,  being  generally  the  cause,  and  not  the  effect,  of  the 
morbid  action ;  and  in  the  second,  that  the  inflammation  being 
removed  from  the  coats  of  the  vein,  the  vessel  would,  upon  re- 
moval of  the  clot,  become  pervious.  But  such  is  not  the  case. 
Let  the  clot  be  removed  ever  so  often,  it  is  sure  to  form  ai^ain, 
and  nothing  has  the  power  of  overcoming  the  inflammation  of 
the  vessel  until  it  has  been  transformed  into  an  oroanized  cord 
— a  process  most  materially  hastened  by  the  application  of  a 
blister. 

I  think  it  may  therefore  be  accepted  that  external  irritants — 
whether  they  be  simply  rubefacients,  producing  a  mere  redness 
of  the  skin,  vesicants  or  blisters,  which  cause  elevations  of  the 
cuticle  by  fluid  underneath  it,  or  cauterization  and  setons,  which 
promote  the  suppurative  action — remove  lameness  by  assisting 
nature  in  a  process  of  repair. 

Rubefacients  may  be  employed  in  the  less  severe  forms  of 
lameness,  in  sprains  of  tendons,  or  in  slight  affection  of  joints, 
along  with  rest  and  fomentations,  after  the  more  acute  symp- 
toms have  passed  away. 

Blisters. — It  is  usual  to  apply  blisters  in  all  cases  of  some 
standing,  when  organic  changes  in  the  parts  involved  are  sus- 
pected. Before  a  blister  is  applied,  the  hair  should  be  clipped 
from  the  part,  which,  if  dirty,  ought  to  be  washed,  and  when 
dry,  the  blister  to  be  applied  with  smart  friction  for  about  ten 
minutes.  To  obtain  the  full  effect  of  a  blister,  a  quantity  of 
ointment  is  to  be  thickly  laid  on  after  the  rubbing-in  is  com- 
pleted. 

The  best  agent  is  cantharides,  in  the  form  of  acetate,  tincture, 
or  ointment ;  to  the  limbs,  the  ointment  in  preference ;  one  part 
of  cantharides  to  twelve  parts  of  lard  or  palm  oil.  If  prepared 
with  a  temperature  equal  to  the  boiling-point  of  water  (212°), 
it  will  be  sufficiently  strong,  and  will  never  blemish.  It  is 
a  mistake  to  think  that  the  powdered  flies  should  be  mixed 

Y 


S22  TREATMENT  OF  LAMENESS. 

with  the  vehicle  when  it  is  nearly  cold :  an  ointment  so  pre- 
pared will  require  three  times  the  quantity  of  cantharides, 
The  heat  melts  the  cantharidine. 

Hints  iqoon  Uistering  generally. — No  more  than  two  legs  are 
to  be  blistered  at  one  time,  and  three  weeks  at  least  must  be 
allowed  to  elapse  before  the  others  are  blistered,  and  between 
each  re-application.  It  is  bad  practice  to  blister  extensively  in 
v^y  hot  weather ;  and  it  is  a  mistake  to  suppose  that  blisters 
to  the  loins  and  back  are  more  apt  to  irritate  the  urinary  organs 
than  when  applied  to  any  other  part  of  the  body,  provided  that 
it  be  carefully  and  properly  done. 

The  evil  results  of  blistering  are — 

1st.  The  production  of  strangury,  by  the  absorbed  cantharidine 
irritating  the  urinary  passes.  This  is  a  very  rare  occurrence, 
provided  the  blister  has  been  applied  to  a  moderate  extent  of 
surface ;  but  if  four  legs,  or  even  two,  be  very  extensively 
blistered  at  one  time,  the  occurrence  of  such  may  be  laid  down 
to  the  indiscretion  of  the  practitioner.  In  some  cases,  however, 
very  moderate  blistering  is  followed  by  strangury,  and  when  it 
does  occur,  it  is  best  treated  thus : — First  wash  the  blistered 
surface  with  warm  water,  in  which  a  little  alkali  has  been  dis- 
solved ;  dress  it  with  oil ;  give  the  animal  demulcents  to  drink, 
such  as  cold  linseed  tea ;  and  administer  a  few  doses  of  opium 
and  bicarbonate  of  soda. 

2d.  The  production  of  a  considerable  amount  of  nervous 
irritability,  fidgetiness,  quickened  pulse,  and  injected  mucous 
membranes,  with  loss  of  appetite.  These  symptoms  are  due 
to  a  nervous  temperament ;  and  if  not  very  severe,  had  better 
not  be  interfered  with.  Should  they  become  alarming,  the 
animal  must  be  treated  as  in  the  first  instance ;  the  fomenta- 
tions being  continued  for  a  longer  period  to  the  legs.  It  may 
be  here  mentioned  that  fomentations  should  not  be  hot,  but 
soothingly  warm. 

2>d.  Sometimes  blisters,  no  matter  how  carefully  applied, 
produce  excessive  swellings  of  the  limb  or  limbs,  with  a  ten- 
dency to  suppuration  and  sloughing  of  the  skin.  These  re- 
sults are  generally  due  to  the  animal  being  in  bad  health, 
and  in  a  condition  tending  to  anasarca  or  to  erysipelatous 
disease.  The  treatment  must  consist  of  purgatives  or  diuretics, 
as  the  case  may  be,  fomentations,  astringent  lotions,  and  gentle 


BLISTERING. 


323 


exercise,  as  soon  as  the  pain  is  sufficiently  subsided  to  admit 
ot  tlie  animal  being  moved  about.  In  many  cases  the  swellinc-s 
involve  the  sheath  of  the  penis  and  the  under  surface  of  the 
abdomen.  Punctures  are  very  useful  in  such  parts,  by  allow- 
ing the  escape  of  the  contained  fluid.  I  have  seen  tetanus 
arise  from  a  very  limited  blister  to  one  fore  leg 

It  is  necessary  to  tie  tlie  horse's  head  to  the  rack  after  a 
Wister  has  been  applied,  in  order  that  lie  may  not  bite  it 
or  lick  It  with  his  lips  or  tongue,  and  thus  blister  the  mouth 
and  blemish  the  blistered  spot.  It  is  also  necessarv  to  tie  the 
head  so  that  the  horse  cannot  lie  down,  for  if  he  li^s  upon  the 
Mistered  limb  the  vesicant  will  adhere  to  that  part  of  the  body 
brought  m  contact  with  it  whilst  the  animal  is  recumbent,  and 
produce  an  effect  upon  it  as  well  as  upon  the  part  to  which  it 
has  been  purposely  applied.  If  the  blistered  spot  be  within 
reach  of  the  tail,  the  tail  should  be  tied  up,  or  it  is  apt  to 
become  daubed,  and  the  blister  whipped  on  to  the  thighs,  sheath 
or  mammary  gland.  ' 

If  the  effects  are  not  sufficiently  apparent  in  about  thirty 
hours  after  the  blister  has  been  applied,  a  very  little  more  or 
what  IS  remaining  on  the  skin,  which  may  be  sufficient,  should 
be  gently  rubbed  in ;  and  in  about  forty-eight  hours  after  the 
application  the  part  is  to  be  waslied,  and  every  trace  of  the 
blister  removed;  a  little  oU  being  now  applied,  or,  what  suits 
pediaps  better,  an  emulsion  of  sweet  oil,  carbonate  of  potash 
and  water.  It  is  a  mistake  to  keep  the  parts  soft  too  Ion"' 
the  eschars  should  be  aUowed  to  accumulate,  and  to  desquamate 
gradually.  ^ 

When  the  head  is  untied  from  the  rack,  a  cradle  must  be 
put  on  the  anmial's  neck  to  prevent  him  from  biting  the  blistered 
spot  A  cradle  is,  however,  useless  when  the  lower  part  of 
the  fore  legs  is  blistered,  since  the  animal  can  elevate  his  feet 
Irom  the  ground,  and  thus  get  at  them  with  his  teeth;  and 
when  he  is  lying  the  cradles  are  of  very  little  use  when  a  blister 
IS  below  the  knee.  In  such  cases  the  best  method  is  to  keep 
the  head  tied  up  until  a  thick  scab  is  formed,  which  will  destroy 
itchiness  in  the  part. 

Firing,  or  the  application  of  the  actual  cautery,  is  supposed 
by  some  to  be  beneficial  in  acting  as  a  suppurant,  and  by  others 
m  lormmg  a  permanent  bandage  round  the  part;  but  I  appre- 


324  TREATMENT  OF  LAMENESS. 

liend  there  is  not  much  truth  in  either  of  these  suppositions.  It 
is  a  much  more  severe  irritant  than  a  blister,  and  often  removes 
pain  very  rapidly  when  repeated  blisters  have  failed  to  do  so. 
In  bone  diseases,  and  in  all  causes  of  chronic  lameness,  it  is  of 
great  benefit,  and  seems  to  act  by  powerfully  exciting  the  heal- 
ing process  in  the  part  diseased. 

The  firing  may  be  in  lines,  and  superficial,  the  transverse 
method  being  the  least  calculated  to  blemisli ;  or  it  may  be  in 
points,  and  deep,  by  pyro-puncture  (see  drawing  of  instrument, 
rig.  24,  page  159),  and  into  the  diseased  structure.  This 
latter  method  is  the  more  easily  performed,  and  the  more 
effective. 

Nothing  is  more  calculated  to  dispel  the  idea  of  the  correct- 
ness of  the  cou7iter-irritSitioii  theory  than  the  dissection  of  a 
part  which  has  been  recently  fired  (say  three  days  after  tlie 
operation),  when  it  will  be  found  that  the  skin,  subcutaneous 
tissue,  and  the  bones — when  they  are  superficially  situated,  such 
as  those  of  the  hock,  pastern,  &c. — are  involved  in  the  inflam- 
matory action  so  induced.  Thus  a  bone-spavin  lameness  is 
removed  by  the  inflammation  excited  by  the  cautery  in  the 
diseased  bones,  providing  a  supply  of  material  for  the  purpose 
of  uniting  them  together  into  one  immoveable  mass ;  or,  as  in 
caries  of  a  ginglymoid  joint,  for  the  repair  of  destroyed  structure, 
as  already  explained. 

Setons  act  very  satisfactorily  in  some  cases  of  bone  diseases, 
especially  in  those  accompanied  by  external  heat  of  the  part ; 
they  produce  a  discharge  of  pus,  and  their  action  can  be  con- 
tinued for  a  much  longer  time  than  that  of  blistering  or  firing. 
In  tendinous  or  ligamentous  lamenesses,  with  much  thickening 
of  the  integuments  and  subcutaneous  structures,  setons  should 
not  be  employed,  as  they  leave  much  additional  thickening,  and 
are  not  so  effectual  as  the  actual  cautery. 


CHAPTER  XVIII. 

DISEASES  OF  THE  FEET. 

PRELIMINARY  OBSERVATIONS  ON  SHOEING — FOOT  LAMENESS,  DIVIDED 
INTO  THREE  KINDS (1.)  DISEASES  OF  THE  BONES  AND  CAR- 
TILAGES ;   (2. )   DISEASES   OF   THE     HORN-SECRETING    STRUCTURES  ; 

(3.)     ACCIDENTAL     INJURIES DISEASE     OE    THE    PYRAMID   OF   OS 

PEDIS — SIDE-BONES NAVICULAR  DISEASE,  THEORIES  OF CAUSES, 

PATHOLOGY,  AND  TREATMENT NEUROTOMY,  ITS  FAVOURABLE  AND 

UNFAVOURABLE     EFFECTS GELATINOUS     DEGENERATION    OF    THE 

NAVICULAR   BURSA PATHOLOGICAL    ANATOMY — COMPARISON    TO 

WHITE  SWELLING. 


PRELIMINARY  REMARKS  ON  SHOEING. 

There  is  no  subject  that  calls  for  more  attention  than  tte 
consideration  of  the  feet  of  the  horse.  At  the  present 
time,  SO  great  is  the  ignorance  prevailing  amongst  owners, 
shoers,  and  managers  of  horses,  that  the  majority  of  lame- 
nesses are  found  to  arise  from  mismanagement  of  these 
important  parts  of  the  animal  frame.  In  the  city  of  Edin- 
burgh above  60  per  cent,  of  the  horses  engaged  for  all  pur- 
poses are  lame,  and  above  80  per  cent,  of  such  are  lame  in  one 
or  both  fore  feet.  In  many  English  towns,  especially  in  London, 
the  lame  horses  to  be  seen  in  the  streets  are  very  few  compared 
with  those  of  Edinburgh ;  but  even  in  the  most  favoured  parts 
of  the  kingdom  the  number  is  something  enormous  compared 
with  other  countries ;  and  well  might  the  late  Professor  Sewell 
say  that  he  had  seen  more  lame  horses  between  Dover  and 
London  than  during  a  sojourn  of  three  months  in  France  and 
other  continental  countries. 

The  writers  upon  the  management  of  the  horse's  feet  and  upon 
shoeing  are  very  numerous,  embracing  all  classes  of  men,  from 
peers  of  the  realm  down  to  the  groom  and  shoeing-smith ;  but 


326  DISEASES  OF  THE  FEET. 

an  analysis  of  their  writings  shows  that  the  work  of  one  is 
often  a  mere  repetition  of  that  of  another.  Nearly  all  have  run 
in  the  same  groove,  promulgating  false  ideas  from  one  genera- 
tion to  another,  to  the  incalculable  deterioration  of  the  useful- 
ness of  the  horse.  Indeed,  such  is  the  prejudice,  and  so  deeply 
rooted  are  men's  opinions,  that  it  is  dangerous  for  any  one 
to  teach  a  more  rational  doctrine.  If  such  an  one  is  nov/ 
and  then  bold  enough  to  point  out  the  errors  of  the  past,  he 
stands  a  fair  chance  of  being  considered  a  dreamer,  or  something 
worse. 

Nearly  all  writers  upon  the  subject  have  looked  upon  the  foot 
as  a  very  wonderful  and  complex  piece  of  mechanism,  and  seem- 
ingly have  forgotten,  or  have  not  known,  that  no  matter  how 
complex  it  may  be  within,  it  is  enclosed  in  a  simjjle  horny 
box ;  that  all  the  efforts  of  shoeing  should  be  directed  to  pre- 
serve that  box  in  a  natural  condition ;  and  that  its  position  in 
relation  to  the  limb  should  not  be  altered  by  the  shape  or  form 
of  the  shoe. 

Many  have  maintained,  and  some  still  maintain,  that  the 
horny  foot  is  an  elastic,  expanding,  and  contracting  organ, 
and  that  its  elasticity  should  be  kept  intact  by  paring  the  sole, 
peculiar  nailing  on  of  the  shoe,  and  by  keeping  the  foot  as  moist 
as  possible,  by  stuffing,  spongio-piline,  &c.  Others,  again,  sup- 
pose that  a  mechanical  advantage  can  be  given  to  its  tendons 
and  ligaments  by  the  form  of  the  shoe ;  in  fact,  by  improving 
upon  nature. 

All  these  are  errors,  and  have  originated  with  men  who 
have  built  their  conclusions  upon  mere  hypotheses.  It  is  not 
my  intention  here  to  enter  minutely  into  the  question  of 
horse-shoeing,  but  merely  to  state,  in  the  first  place,  that  it  is 
essential  to  abolish  the  drawing-knife ;  and  in  the  second,  that 
calkins  and  toe-pieces  should  be  done  away  with  for  all  kinds 
of  horses  except  those  used  for  heavy  draught  in  towns  where 
the  streets  are  paved  and  steep.  All  horses  required  to  go 
beyond  a  walking  pace  are  injured  by  shoes  with  turned-up 
heels  and  toes.  Farm -horses,  and  those  employed  upon 
macadamised  roads,  are  better  without  than  with  heel  and 
toe-pieces,  although  the  pace  they  are  required  to  go  is  never 
faster  than  tlie  walk  ;  in  fact,  where  possible,  all  horses  should 
be  shod  with  a  flat  shoe. 


REMARKS  ON  SHOEING. 


327 


The  form  of  the  shoe  which  I  recommend  is  represented  in 
the  following  woodcuts ;  and  it  ought  to  be  so  made  and  fitted  as 


Fig.  55.  ^  Tig.  56. 

Fig.  55. — Inferior  (concave)  surface  of  shoe. 
Fig.  56. — Superior  (flat)  surface  of  shoe,  bearing  on  the  sole. 

to  bear  upon  all  parts  of  the  sole  and  crust  that  are  calculated  to 
bear  pressure.  Experience  and  anatomical  investigation  point 
to  the  conclusion  that  the  sole 
as  well  as  the  crust  is  intended 
to  perform  this  weight-bearing 
function :  the  sole  around  the 
margin  of  the  crust  for  the  dis- 
tance of  about  half-an-inch  in 
all  parts  of  the  foot  except  at 
the  heels — i.e.,  that  part  of  it 
embraced  in  the  triangle  be- 
tween the  wall  and  bar ;  in  fact, 
the  seat  of  corn.  Here  the  shoe , 
should  rest  upon  the  wall  only, 
being  made  sufficiently  narrow 
at  this  part  (as  seen  in  Figs.  55, 
56).    By  the  application  of  such      _ 

■I  IT  o  i.^       c     I.       1  ^^®  ^^^^  prepared  for  the  shoe.     The 

a  SllOe,  ail  parts   Ol   the  toot  Cal-    sole,  frog,  and  bars  untouched  with  the 

Culated  to  bear  Weidlt  are  called    ^^^^^  ^^^  ^^^  years  ;  the  natural  length 
.  „  7i     •  ,         1    ^^  *o®  ^^^  depth  of  wall  kept  in  their 

upon    to    periorm    their   natural    relative  positions  by  the  rasp  only. 

function  ;  the  various  structures 

kept  in  their  proper  and  relative  position ;  the  frog  allowed  to 

come  to  the  ground  to  prevent  concussion;  the  weight  of  the 


Fig.  57. 


328  DISEASES  OF  THE  FEET. 

animal's  body  diffused  over  an  extended  surface,  and  not  limited 
to  the  wall  alone,  as  in  the  common  method  of  shoeing  with  a 
seated  shoe  ;  slipping  prevented,  by  the  rim  of  the  concave  shoe 
and  the  wedge-shaped  frog  grasping  the  ground. 

This  method  of  shoeing  has  been  practised  at  the  forge  of  the 
College  with  the  most  beneficial  results  for  several  years,  and 
even  in  such  a  city  as  Edinburgh,  where  the  streets  are  so  steep 
and  slippery,  with  the  great  advantage  that  horses  slip  less  than 
when  shod  with  turned-up  heels.  I  feel  quite  convinced  that,  if 
such  a  shoe  were  generally  adopted,  lameness  in  the  feet  would 
be  much  more  rarely  met  with ;  but  such  is  the  prejudice,  even 
amongst  those  who  have  the  opportunity  of  seeing  the  beneficial 
results  of  the  system,  that  it  is  almost  impossible  to  convince 
them  that  it  is  an  improvement.  One  large  cab  proprietor  says 
— "  All  my  lame  horses  go  better  in  your  narrow-heeled  shoes, 
especially  my  '  groggy  horses  ;'  "  but  even  he  will  not  have  his 
sound  horses  so  shod. 

As  to  the  desirability  of  pressure  upon  the  sole,  my  views  are 
borne  out  by  many  practical  men,  especially  by  Mr.  Broad  of 
Bath,  a  gentleman  who  has  studied  the  subject  very  deeply.  His 
essay  upon  horse-shoeing,  which  gained  the  second  prize  of  £30, 
given  imder  the  auspices  of  the  Scottish  Society  for  the  Preven- 
tion of  Cruelty  to  Animals,  is  replete  with  instructive  matter, 
and  ought  by  all  means  to  be  published. 

It  must,  however,  be  borne  in  mind  that  the  sole,  to  bear  its  due 
proportion  of  weight,  should  be  left  unmutilated  by  the  knife. 

To  return  to  the  subject  of  lameness.  The  diseases  of  the  feet 
may  be  arranged  as  follows  : — 

1st.  Diseases  of  the  bones  and  cartilages. 

2d.  Those  originating  in  the  horn-secreting  structures  ;  and, 

Zd.  Accidental  injuries. 


I. — LAMENESS  FROM  DISEASE  OF  THE  PYRAMIDAL  PROCESS  OF  THE 

OS  PEDIS. 

This  form  may  exist  either  in  a  fore  or  a  hind  foot,  and  results 
from  blows  upon  the  front  of  the  coronet,  or  from  over-extension 
of  the  extensor  tendon  (attached  to  the  point  of  the  pyramid)  by 
the  use  of  high  calkins. 


DISEASE  OF  THE  OS  PEDIS.  329 

Symptoms. — Swelling  on  the  front  of  tlie  coronet,  varying  in 
size  from  that  of  a  liazel  nut  to  that  of  a  pigeon's  egg,  witli 
lameness,  which  is  often  very  persistent.  The  peculiarity  of 
gait  is  manifested  by  the  horse  putting  the  heel  down  first,  and 
often  taking  the  foot  up  very  quickly  as  soon  as  the  toe  comes 
in  contact  with  the  ground.  There  will  he  pain  on  pressure, 
and  some  heat ;  now  and  then  the  skin  over  the  enlargement 
sloughs,  leaving  a  wound,  which  heals  with  difficulty;  or  a 
wound  may  be  present  from  the  first,  if  the  injury  has  been  due 
to  external  violence. 

Treatment. — Low-heeled  bar  shoe;  fomentations,  poultices, 
and  rest ;  succeeded  by  blisters,  or  the  application  of  the  actual 
cautery.  In  some  cases  the  lameness  resists  the  most  active 
treatment,  and  upon  examination  after  death,  caries  is  found  to 
have  destroyed  the  pyramid  of  the  bone,  and  extended  into  the 
pedal  articulation.  Neurotomy,  if  there  be  a  good  foot,  might 
be  tried  in  cases  that  resist  all  other  treatment. 


n. — OSSIFICATION  OF  THE  LATERAL  CAETILAGES. 

Side-Bones. — Commonly  met  with  in  heavy  horses,  and  in 
the  fore  feet.  I  have  seen  the  lateral  cartilages  of  the  hind  ones 
ossified ;  but  this  is  very  rare,  and,  so  far  as  I  know,  never  occa- 
sions lameness. 

The  lateral  cartilages  are  two  thin  plates  of  fibro-cartilage,  of 
an  irregularly  quadrangular  form,  surrounding  the  wings  of  the 
OS  pedis,  which,  in  virtue  of  their  elasticity,  assist  the  sensitive 
frog  and  soft  structures  of  the  foot  in  regaining  their  natural 
position  after  being  pressed  upwards  and  outwards  by  the  weight 
of  the  animal.  An  opinion  prevails  that  these  fibro-cartilagin- 
ous  bodies  assist  in  the  expansion  of  the  foot.  Undoubtedly 
they  expand  at  their  posterior  border  each  time  the  animal  puts 
his  foot  to  the  ground ;  but  in  this  expansion  of  the  heel  they 
are  mere  passive  agents,  being,  in  fact,  pressed  outwards  by  the 
structures  contained  in  the  space  between  them.  They  are, 
however,  active  agents  in  causing  the  contraction  of  the  heel; 
for  when  the  pressure  is  removed  from  their  inner  surfaces,  they 
then  tend  to  assume  their  natural  position  in  virtue  of  their 
elasticity;  and  the  pressure  they  exercise  upon  the  sensitive 
frog  forces  the  heel  into  its  original  shape.     Briefly,  they  may 


ooO 


DISEASES  OF  THE  FEET. 


be  said  to  be  forced  to  expand  when  the  foot  is  on  the  ground, 
and  that  they  actively  assist  contraction  when  the  weiglit,  which 
forces  the  sensitive  frog  upwards  and  outwards,  is  removed  from 
the  foot. 

It  must  not  be  understood  that  I  am  advocating  the  theory 
that  the  foot  expands  upon  its  inferior  surface  ;  that  supposition 
is  now  entirely  disregarded ;  but  no  one  can  deny,  what  is  ap- 
parent to  the  most  ordinary  observer,  that  the  foot  expands  at 
the  coronet  and  heels ;  not  the  horny  foot,  but  the  soft  parts  of 
the  heels  and  coronet.  To  prevent  undue  expansion  of  these, 
the  lateral  cartilages  are  placed  as  elastic  sides. 

Ossification  of  the  Lateral  Cartilages. — ^As  already  stated,  side- 


FiG.  58  sliows  osaifioation  of  the  lateral  cartilages,  with 
fracture  of  the  altered  structure  upon  one  side,  at  its  jmic- 
tion  with  the  pedal  bone. 

bones  are  commonly  met  with  in  heavy  draught  horses ;  indeed, 
a  great  majority  of  this  class  is  found  so  affected  by  the  time  the 
animal  is  six  or  seven  years  old ;  and  this  seems  to  arise  from 
the  over-expansion  of  the  cartilages  caused  by  the  great  weight 
of  the  animal.  Tlie  process  of  ossification  is  very  often  a  slow 
one,  unaccompanied  by  any  acute  inflammatory  action,  giving 
the  animal  no  pain,  and  causing  no  lameness. 

The  causes  of  ossification  of  these  cartilages  are — hereditary 
tendency,  and  shoeing  with  high  calkins.  It  is  generally  ad- 
mitted that  the  predisposition  to  side-bones  is  hereditary,  and 


OSSIFICATION  OF  THE  LATERAL  CARTILAGES.  331 

many  breeders  of  the  best  class  of  cart-horses,  being  aware  of 
the  fact,  are  careful  not  to  breed  from  an  animal  with  them. 

High-heeled  shoes  prove  a  cause : —  Ist.  Because  the  shock 
received  by  the  heels  when  the  foot  comes  to  the  ground  is 
transmitted  directly  to  the  cartilages ;  2d.  Because  the  pres- 
sure upon  the  heels  of  the  wall  is  unnatural  and  excessive,  the 
frog  being  prevented  from  bearing  its  proper  proportion ;  and, 
od.  Because  they  are  pulled  inwards  and  downwards  by  the 
sensitive  frog  being  pressed  downwards,  whilst  it  horny  covering, 
being  removed  from  the  ground,  forms  no  column  of  support. 

Side-bones  are  a  cause  of  unsoundness,  but  all  horses  so 
affected  should  not  be  condemned  on  this  accoimt,  and  it  may 
be  laid  down  as  a  general  rule,  that  if  the  feet  are  strong,  open, 
and  well  developed,  the  horse  showing  no  lameness  should 
not  be  condemned  for  side-bones.  But  if  he  is  stilty  in  his 
action,  >  even  without  actual  lameness,  or  if  the  feet  be  con- 
tracted, altered  in  form,  weak  in  the  heels,  flat  or  convex  in  the 
sole,  there  should  be  no  hesitation  in  pronouncing  him  unsound. 

Occasionally  the  lighter-bred  horse  is  found  to  have  side- 
bones,  which  are  usually  attended  with  lameness ;  whether  lame 
or  not,  such  an  animal  is  unsound,  since  he  is  unfit  to  perform 
his  ordinary  labour,  as  trotting  upon  the  roads  is  sure  to  set  up 
the  inflammatory  process  in  the  cartilage,  and  cause  lameness. 

To  detect  these  deposits,  it  is  necessary  to  press  upon  the 
cartilages ;  naturally,  these  are  yielding  and  elastic,  but  when 
ossified  they  lose  this  character,  becoming  hard,  unyielding, 
and  enlarged.  The  deposition  of  bone  may  be  uniform,  in- 
volving the  whole  substance  of  the  fibro-cartilage,  or  it  may 
be  in  isolated  spots,  either  at  the  junction  of  the  cartilage  witli 
the  pedal  bone  anteriorly,  or  involving  the  posterior  borders, 
forming  a  hard  kernel-like  enlargement. 

The  anterior  side-bone  more  commonly  causes  lameness  than 
the  posterior  one. 

Side-bones  differ  from  ring-bones,  both  in  the  structures  they 
involve  and  the  lameness  they  occasion.  Side-bone  lameness 
is  characterised  by  the  toe  of  the  foot  being  first  brought  to  the 
ground;  when  both  feet  are  involved,  by  a  shortness  of  step 
and  want  of  elasticity  or  springiness  in  action,  resembling  that 
of  navicular  disease. 

Treatment. — Bar  shoe ;  rest,  blisters,  firing ;  and  should  these 


332  DISEASES  OF  THE  FEET. 

fail,  neurotomy.  The  French  operation  of  removing  the  deposits 
by  excision  has  not  found  much  favour  in  this  country,  nor  do 
I  think  it  likely  that  it  will  do  so,  as  the  incurability  of  the 
lameness  is  generally  due  to  other  structures  besides  the  lateral 
cartilages  being  involved  in  the  diseased  process.  An  examina- 
tion of  Fig.  5  in  Photo-lithograph,  Plate  III.,  will  illustrate 
this,  and  throw  a  light  upon  the  circumstance  that  side-bones 
are  occasionally  the  cause  of  incurable  lameness. 

Neurotomy  is  very  successful  in  removing  this  form  of  lame- 
ness, and  is  attended  with  more  permanently  beneficial  results 
than  when  performed  for  navicular  disease. 

It  will  be  useful  to  bear  in  mind  that  when  these  cartilages 
are  ossified,  the  horse's  gait  will  lose  that  elasticity  which  is 
so  essential  to  good  action.  In  the  cart-horse  this  is  not  of 
much  consequence,  but  in  the  horse  required  for  other  paces 
than  the  walk,  it  is  of  the  greatest  importance,  not  only  as  a 
question  of  soundness  or  unsoundness,  but  of  the  usefulness  of 
the  horse  and  safety  of  the  rider  or  driver. 

III. — NAVICULAR  DISEASE. 

This  is  the  most  fertile  cause  of  lameness  that  we  know  of 
in  the  better-bred  horse — the  bane  of  horse-flesh.  At  one  time 
all  cases  of  obscure  lameness  in  the  fore  extremity  were  attri- 
buted to  the  shoulder ;  but  after  the  discovery  of  James  Turner, 
all  were  said  to  arise  from  navicular-joint  disease. 

Should  the  student  desire  the  history  of  this  disease,  he  will 
find  it  treated  very  fully  by  Percivall  in  his  book  on  Lame- 
ness (1849).  It  was  called  navicular  arthritis  (Percivall),  and 
podotrocholitis  (Brauel)  ;  and  has  been  ascribed  to  various  con- 
ditions, such  as  contraction  of  the  foot  (Coleman)  ;  laceration 
of  the  fibres  of  the  perforans  tendon,  as  it  passes  under  the 
navicular  bone  (Dick)  ;  inflammation  of  the  synovial  membrane 
(Turner,  Percivall,  and  others) ;  inflammation  of  the  synovial 
membrane  only,  or  of  that  and  the  navicular  bone  (Brauel)  ; 
and  inflammation,  having  its  origin  in  the  interior  of  the  navi- 
cular bone,  leading  to  exostoses  on  or  caries  of  the  inferior 
articulating  surface,  with  degeneration  of  the  fibres  of  the  tendon 
(Broad  of  Bath),  and  its  causes  to  a  variety  of  circumstances, 
as  best  suited  the  whim  and  fancy  of  the  theorist ;  such  as 


NAVICULAR  DISEASE.  333 

non-paring  of  the  foot,  destroying  its  elasticity  (Coleman)  ;  a 
shoe  thick  at  the  toe,  causing  increased  resistance  to  the  action 
of  the  flexors,  and  rendering  the  perforans  tendon  hable  to 
strain  (Dick)  ;  thin-heeled  shoes,  by  throwing  the  weight  and 
concussion  on  the  posterior  parts  of  the  foot  and  frog,  bruising 
the  synovial  membrane ;  hereditary  tendency ;  bad  shoeing ; 
bad  nailing  ;  want  of  exercise  ;  too  much  exercise,  &c. 

I.  Contraction  of  the  Foot. — Messrs.  Turner  and  Percivall 
wrote,  that  "of  contraction  there  may  be  two  kinds.  Ist.  A 
contraction  of  the  heels,  called  lateral  contraction;  2d.  Con- 
traction of  the  hoof  from  below  upwards,  or  veHical  contraction  ;" 
and  these  were  said  by  Professor  Coleman  to  be  the  cause  of 
this  lameness.  He  maintained  that  "  expansion  of  the  hoof 
is  effected  by  pressure  upwards  of  the  frog,  and  pressure  down- 
wards of  the  navicular  bone.  By  properly  thinning  of  the 
sole,  rasping  the  quarters,  lowering  the  heels,  giving  the  frog 
pressure,  and  keeping  the  horse  in  a  pond  all  day,  or  else  tied 
up  with  his  lame  feet  in  a  tub  of  water,  we  have  no  difficulty 
in  removing  contracted  hoofs.  Although  difficulty  there  be 
none,  however,  in  restoring  the  original  form  of  the  hoof, 
we  too  frequently  find  we  have  gained  nothing  by  it,  because ' 
we  have  not  restored  the  original  structures  of  the  parts  con- 
tained wdthin  the  hoof.  Contraction  of  the  hoof  in  consequence 
of  the  internal  parts  being  squeezed  produces  inflammation  of 
the  laminae,  and  ossification  of  them.  This  causes  the  horse, 
in  galloping,  to  avoid  to  his  utmost  coming  down  upon  his 
heels,  or  to  tread  upon  hard  ground ;  the  concussion  at  such 
times  being  great  from  loss  of  elasticity  in  the  laminse,  so  that 
the  moment  he  comes  to  work  he  falls  lame.  In  nine  cases 
out  of  ten  of  what  are  termed  '  groggy  *  or  '  foundered ' 
horses,  these  parts,  in  consequence  of  chronic  inflammation, 
become  altered  in  structure ;  effusion  of  lymph  or  bony  matter 
taking  place."  I  have  thought  it  expedient  to  make  this 
extract  from  Coleman,  in  order  to  show  the  kind  of  pathology 
taught  by  him ;  and  I  hope  to  be  able  to  point  out  the  mischief 
brought  about  by  it — conclusions  and  generalities  without  one 
fact  to  support  them. 

Contraction  of  the  hoof  is  not  a  cause,  but  an  effect,  of 
disease ;  an  atrophy  of  the  structures  contained  within  the  horny 
box  consequent  upon  diminished  functional  activity  and  adapta- 


334  DISEASES  OF  THE  FEET. 

bility  of  the  hoof  to  the  atrophied  structures,  which  it  encloses 
and  protects.  Professor  Dick  said  there  was  a  kind  of  con- 
traction of  the  hoof,  in  fact  a  naturcd  tendency  to  this  in  the 
domesticated  animal,  arising  from  a  want  of  moisture  when  he 
is  confined  in  the  stable.  This  kind  of  contraction,  he  main- 
tained, did  not  cause  lameness,  "  as  the  soft  parts  became 
adapted  to  the  alteration  of  the  hoof."  Now,  in  my  opinion, 
this  kind  of  contraction  would  be  the  one  most  likely  to  cause 
lameness  ;  indeed,  it  would  be  impossible  for  an  animal  not  to 
be  so,  if  the  pressure  of  the  drying  hoof  were  sufficient  to  cause 
atrophy  and  absorption  of  the  sensitive  tissues  within.  That 
horses'  feet  do  become  contracted,  more  especially  at  the  heels, 
without  lameness,  I  do  not  deny.  I  do  not  think,  however, 
that  this  is  due  to  any  want  of  moisture,  but  to  the  removal 
of  the  horn  from  the  heels  and  sole  during  the  operation  of 
shoeing,  for  the  parts  contracted  are  those  situated  posterior 
to  the  wings  of  the  os  pedis,  where  the  space  between  the  two 
quarters  and  heels  of  the  hoof  is  filled  by  the  elastic  sensitive 
frog,  a  structure  possessing  but  little  sensibility.  The  great 
barriers  to  the  collapse  of  the  hoof  at  this  part  are  strong 
heels,  bars,  and  sole  ;  but  if  the  smith,  by  the  so-called  "  open- 
ing of  the  heels,"  remove  such  a  quantity  of  horn  as  to  weaken 
the  foot,  can  we  wonder  that  it  collapses,  and  that  its  sides 
approximate  each  other  too  closely  ? 

Sometimes  one  foot  may  be  found  contracted  through  its 
whole  extent  without  lameness.  This  may  be  due  to  some 
natural  peculiarity  in  the  animal,  just  as  we  find  that  a  man 
may  have  one  foot  smaller  than  its  fellow ;  or  it  may  arise 
from  the  circumstance  of  the  animal  having  been  lame  in  that 
foot  or  that  limb  while  young.  I  have  often  found  a  small 
foot  to  be  due  to  a  previous  lameness  in  any  part  of  the  limb 
or  the  foot,  and  to  accidental  circumstances.  The  explanation 
is  easy.  "When  an  animal  is  lame  in  any  part  of  the  limb,  he 
avoids  putting  weight  on  the  foot  of  that  limb;  the  conse- 
quence is  loss  of  function  and  wasting,  and  in  the  young 
animal,  a  cessation  of  growth ;  whilst  the  opposite  foot,  having 
to  bear  more  than  its  proper  share  of  Av^eight,  becomes  enlarged 
in  all  directions ;  in  fact,  grows  rapidly,  in  order  that  it  may 
be  able  to  maintain  the  extra  amount  of  weight  thrown  upon 
it.     The  disparity  between  the  feet  will  remain  through  life, 


NAVICULAR  DISEASE.  335 

and  the  animal  may  be  sound.  Again,  both  fore  feet  are 
sometimes  apparently  contracted  without  lameness,  but  if 
examined  closely,  they  will  be  found  to  be  small  and  not  con- 
tracted ;  the  bones  of  the  limbs  will  participate  in  the  peculi- 
arity of  conformation ;  they  will  be  narrow  from  side  to  side, 
and  in  all  probability  the  hind  feet  will  be  small  also.  The 
contraction  of  the  feet  due  to  navicular  disease  will  be  found 
in  the  foot  or  feet  that  are  lame,  and  it  is  an  atrophied  con- 
dition, resulting  from  diminished  function,  disappearing  by 
degrees  if  the  original  disease,  or  the  pain  resulting  therefrom, 
can  be  eradicated ;  for  example,  if  the  original  freedom  of  action 
is  restored  to  the  parts  by  neurotomy,  the  disease  still  being 
present,  the  foot  or  feet  contracted  will  regain  their  original 
dimensions. 

II.  Sprain  or  Laceration  of  the  Fibres  of  the  PerforoMS 
Tendon. — This  was  the  theory  taught  by  Professor  Dick,  and 
accepted  by  myself  and  the  great,  majority  of  his  pupils.  He 
said — "  I  have  endeavoured  to  demonstrate  that  primary  and 
permanent  disease  is  established  in  the  synovial  capsule,  between 
the  tendon  and  navicular  bone,  and  arises  from  strain  and  over- 
extension of  the  tendon,  where  it  passes  under  the  navicular  bone. 
It  has  predisposing  causes,  such  as  want  of  paring,  shoeing,  and, 
still  more,  bad  shoeing ;  hereditary  tendency  of  particular  breeds, 
and  high  condition,  for  it  is  a  disease  rarely  of  the  agricultural, 
but  of  the  high-bred  horse.  In  like  manner,  it  has  manifest 
exciting  causes,  such  as  strain  of  the  tendon  and  over-exertion, 
pressure  on  the  sole,  as  from  travelling  with  a  stone  in  the  foot ; 
and  there  is  the  tight  shoe,  exciting  irritation  of  the  foot, 
which,  hot  and  uneasy  in  the  stable,  is  aggravated  by  occa- 
sional and  violent  exercise."  Towards  the  end  of  Professor 
Dick's  career,  the  idea  that  the  disease  was  due  to  laceration  of 
the  tendon  became  more  firmly  held  by  him,  and  that  this  was 
caused  by  bad  shoeing,  that  is  to  say,  by  allowing  the  toe  of  the 
foot  to  be  too  long,  and  applying  a  shoe,  thick  and  irregular  at 
the  toe,  which,  by  increasing  the  resistance  of  the  foot,  when 
implanted  upon  the  ground,  to  the  action  of  the  flexor  muscles, 
threw  an  additional  strain  on  the  tendon  where  it  passes  under 
the  navicular  bone. 

During  the  last  five  years  I  have  made  numerous  post  mortem 
examinations  of  navicular  disease,  and  am  convinced  that  strain 


336  DISEASES  OF  THE  FEET. 

or  laceration  of  the  tendon  is  never  a  primary  condition,  and 
that  the  disease  commences  as  an  inflammation  of  the  cancel- 
lated structure  of  the  navicular  bone,  or  of  the  cartilage  upon  its 
inferior  surface.  It  was  very  hard  for  me  to  believe  that  a 
theory  which  had  so  much  to  support  it,  and  which  I  had  advo- 
cated ever  since  my  student  days,  could  be  erroneous.  I  am 
sure  that  all  the  students  of  my  predecessor  will  remember  how 
enthusiastic  he  was  while  lecturing  upon  this  subject,  and  how 
he  showed  us  specimen  after  specimen  where  the  tendon  was 
lacerated  and  adherent  to  the  bone.  In  order  to  establish  the 
correctness  of  this  view,  it  was  necessary  to  have  provided  a 
specimen  with  the  tendon  diseased  or  lacerated,  and  the  surface 
of  the  bone  in  its  natural,  or  at  least  in  a  slightly  altered  condi- 
tion ;  but  this  could  not  be  done,  and  it  was  taken  for  granted 
that  the  altered  structure  of  the  bone  arose  from  the  primary 
lesion  being  in  the  tendon. 

As  a  mere  speculation,  the  view  that  the  primary  condition 
arose  from  laceration  of  the  tendon  could  do  no  harm ;  but  as  a 
pathological  fact,  influencing  men's  minds  upon  the  question  of 
the  non-removal  or  even  non-prevention  of  this  lameness,  it  has 
done  infinite  harm ;  for  it  involved  the  supposition  that  navicular 
joint  lameness  was  almost  incurable,  and  as  such  it  is  now  looked 
upon  by  the  majority  of  the  profession  and  the  public.  Even 
when  most  enthusiastic  in  my  views  as  to  the  correctness  of  Pro- 
fessor Dick's  theory,  I  was  often  startled  by  seeing  many  cases 
of  navicular  disease,  when  attended  to  in  the  early  stages,  recover 
after  a  short  period  of  rest. 

Pathological  examinations  were  made  by  Professor  Dick  to 
an  extent  surpassed  by  none ;  but  he  contented  himself  with 
investigating  the  condition  of  the  outside  of  the  bone  and  tendon, 
and  if  nothing  was  apparent  there,  the  lameness  was  ascribed  to 
some  other  cause. 

If  navicular  disease  were  due  to  sprain  and  laceration  of  the 
tendon,  how  is  it  that  it  so  very  rarely  aff'ects  the  hind  feet  ?^  Is 
it  because  the  flexors  of  the  hind  extremities  are  more  favourably 

^  I  have  in  my  possession  one  specimen,  sent  me  by  Mr.  Clarlc,  V.S.,  Coupar- 
Angus,  of  acute  inflammation,  with  incipient  ulceration,  of  the  navicular  bone 
of  a  hind  foot ;  but  even  in  this  case,  although  the  symptoms  of  lameness  were  very 
great  and  intractable,  and  were  supposed  by  one  veterinary  surgeon  to  be  due  to 
fracture  of  the  pelvic  bones,  there  is  no  appearance  whatever  of  laceration  of  the 
fibres  of  the  tendon. 


NAVICULAR  DISEASE. 


oo7 


placed  than  those  of  the  fore  limbs  ?  I  think  the  most  devoted 
advocate  of  the  theory  will  scarcely  venture  to  answer  in  the 
affirmative;  but  should  he  feel  inclined  to  think  so,  let  him  watch 
a  horse  in  motion  with  a  load  behind  him,  and  he  will  very  soon 
see  that  the  flexors  of  the  hind  limbs  are  called  more  powerfully 
into  action  than  those  of  the  fore  ones  ;  for  in  addition  to  acting 
as  flexors  of  the  feet  and  pasterns,  they  are  extensors  of  the 
hocks.  If  strain  were  the  cause,  navicular  disease,  owing  to 
the  double  function  the  flexor  perforans  is  called  upon  to  perform, 
and  the  more  powerful  strain  thrown  upon  it  in  the  removal 
of  heavy  loads,  would  be  found  in  the  hind,  and  not  in  the  fore 
feet. 


Fig.  59  represents  the  phalangeal  bones  in  their  naturally  oblique 
position,  and  it  will  be  seen  that  from  the  upper  part  of  the 
long  pastern  {a)  bone,  down  to  the  toe  of  the  os  pedis  (c)  is  a  con- 
tinuous oblique  line.  This  obliquity  of  position  enables  the  bone  to 
act  as  a  spring,  for  the  purpose  of  modifying  concussion.  Every 
horseman  knows  that  the  more  oblique  the  pastern,  the  greater  the 
elasticity  of  step  and  freedom  from  jar  ;  that  the  pace  is  easy  for  the 
horse,  and  delightful  to  the  rider.  The  coronary  bone  (b)  rests  en- 
tirely upon  the  os  pedis,  and  the  navicular  bone  (d)  placed  posteriorly 
bears  no  weight,  but  gives  increased  leverage  power  to  the  tendon  {e). 
It  is  a  muscular  appendage,  like  the  sesamoids,  and  is  not  intended 
to  be  a  weight-supporting  bone. 

Navicular  disease  is  due  to  the  rheumatoid  diathesis  and  to 
concussion,  and  the  liability  to  suffer  from  the  first-named 
cause  originates  in  hereditary  predisposition  and  accidental 
circumstances ;  and  to  the  second  in  conformation  (as  narrow 
feet  with  short  upright  pasterns),  and  in  the  unnatural  altera- 
tion of  the  relative  position  of  the  navicular  and  weight-bearing 

z 


338 


DISEASES  OF  THE  FEET. 


bones,  brought  about  by  the  application  of  shoes  which  are 
either  turned  down,  calkined,  or  made  thicker  at  the  heels 
than  at  the  toes. 


'3/ 


■■.  c 


Fig.  60  represents  the  bones  when  their  position  is  altered  by  a 
thick -heeled  shoe  ;  the  line  is  changed  from  its  natural  obliquity  to  a 
direction  approaching  the  perpendicular.  The  lower  end  of  the  os 
coronse  (b)  is  made  to  rest  upon  the  navicular  {d),  as  well  as  iipon  the 
pedal  bone  (c).  The  navicular  bone  is  made  to  bear  weight  for  which 
it  was  not  intended,  neither  is  its  structiire  calculated  to  do  so.  All 
weight -bearing  bones  have  their  fibres  arranged  to  receive  weight 
upon  their  extremities,  but  the  fibres  of  the  navicular,  and  of  all  the 
sesamoidean  bones  or  muscular  appendages,  are  not  so  arranged,  and 
weight  thrown  upon  them  induces  disease. 

The  development  of  navicular  lameness  from  rheumatoid 
disease  is  occasionally  due  to  what  Professor  Dick  termed 
"  occasional  exercise,"  which  implies  long  periods  of  rest,  inac- 
tivity, and  irregular  work.  Professor  Dick  maintained  that 
during  rest  there  was  a  deficiency  of  synovial  secretion,  and 
that  when  an  animal,  with  his  joints  and  bursas  in  this  dry 
condition,  was  suddenly  put  to  fast  work,  the  effects  of  the 
friction  upon  the  surface  of  tendon,  moving  under  the  bone, 
were  laceration  of  its  fibres  and  navicular  disease.     Whether 


NAVICULAR  DISEASE.  339 

this  dryness  of  the  bursse  be  present  or  not,  it  is  very  true  that 
want  of  exercise  is  a  powerful  predisposing  cause  of  the  disease, 
and,  doubtless,  its  effects  are  due  to  the  localisation  of  a  consti- 
tutional tendency  to  rheumatoid  bursitis — (See  Eheumatoid 
Arthritis.)  The  other  accidental  causes  are  pressure  of  a  stone 
in  the  foot,  impacted  immediately  below  the  bursa,  and  exciting 
inflammation;  punctures,  and  allowing  the  toe  of  the  foot  to 
attain  an  inordinate  length.  The  most  frequent  predisposing 
cause  being  the  abnormally  relative  position  of  the  phalangeal 
bones,  either  arising  from  congenital  formation  of  limb,  or 
induced  by  shoeing  with  thick-heeled  shoes ;  the  exciting  cause 
must  be  looked  for  in  the  pace.  Eace-horses,  so  long  as  they 
are  shod  with  racing  shoes,  rarely  suffer  from  navicular  disease. 
The  pace  with  them  tells  upon  the  column  of  weight-bearing 
bones  and  upon  the  ligaments  and  tendons,  but  when  put  to 
harness-work,  in  carts,  omnibuses,  &c.,  and  shod  with  thick  shoes, 
they  soon  become  unsound. 

Hunters,  again,  are  not  nearly  so  prone  to  become  lame  from 
navicular  disease  as  harness-horses ;  but  if  strain  were  the  cause, 
they  would  be  continually  falling  lame.  They  are,  however, 
shod  with  a  level  shoe,  which  allows  the  frog  to  touch  the 
ground,  and  the  great  concussive  shocks,  which  would  be  other- 
wise inflicted  at  every  jump  the  animal  is  called  upon  to  take, 
are  thus  modified  or  destroyed. 

At  one  time  I  was  of  opinion  that  compression  was  the  cause ; 
that  the  tendon  caused  so  much  pressure  upon  the  bone  as  to 
produce  irritation,  and  gave  the  animal  a  feeling  of  uneasiness 
in  the  first  instance,  as  evidenced  by  "pointing  of  the  foot" 
before  lameness  was  apparent.  I  am,  however,  forced  to  abandon 
this  supposition,  and  to  come  to  the  conclusion  that  "  pointing  " 
indicates  a  condition  of  ostitis  sufficient  to  excite  a  feeling  in 
the  horse  that  something  is  wrong,  which  is  insufficient  to  cause 
actual  lameness. 

Symptoms. — The  lameness  is  manifested  in  two  ways:— Is^. 
Suddenly,  and  perhaps  without  apparent  cause,  very  often  im- 
mediately after  the  horse  is  newly  shod.  It  is  then  attributed 
to  some  fault  in  the  nailing ;  but  on  examination,  nothing  wrong 
is  found  in  the  nailing,  or  that  the  shoe  has  bruised  the  foot  in 
any  part  by  undue  pressure.  After  a  time  this  lameness  may 
disappear,  or  it  may  disappear  from  one  foot,  and  after  an  in- 


340  DISEASES  OF  THE  FEET. 

definite  period  reappear  either  in  the  same  foot  or  its  fellow. 
The  rheumatoid  form  is  thus  manifested.  2d.  By  a  slow  and 
insidious  process  in  one  or  both  feet,  and  this  is  the  most 
common  form;  the  first  noticeable  sign  being  pointing  of  the 
foot,  succeeded  after  a  time  by  "shortness  of  the  step"  and 
lameness,  which  may  be  of  a  transitory  character.  For  example, 
"  a  horse  may  quit  the  stable  apparently  sound,  and  it  very  often 
happens  that  the  rider  or  driver  may  fancy  that  the  horse  now 
and  then  goes  lame.  The  foot  is  examined,  and  nothing  found, 
and  next  morning  he  may  seem  all  right  again.  The  next 
journey  perhaps,  or  rapid  work,  brings  back  the  lameness,  which 
after  a  little  rest  and  a  poultice  to  the  foot  disappears  again ;  he 
may  perhaps  favour  it  a  little,  but  there  is  nothing  of  conse- 
quence the  matter,  but  in  the  end,  if  the  fast  work  is  continued, 
the  case  becomes  confirmed." — (Percivall.) 

The  diagnostic  signs  of  navicular  lameness  are — 1st.  Negative ; 
2d.  Positive.  (1.)  The  negative  signs  are  the  absence  of  injury 
to  any  part  of  the  limb,  and  of  any  apparent  disease.  These  are 
diagnostic  of  foot  lameness,  and  are  of  importance,  as  they  limit 
the  seat  of  the  disease  to  the  foot.  This  region  must  now  be 
explored,  and  lameness  in  the  foot  may  exist  from  various 
causes,  but  in  each  variety  the  signs  are  different.  If  laminitis 
be  present,  there  will  be  heat,  tenderness,  &c.  If  a  corn  be  the 
cause,  its  presence  is  easily  detected;  in  fact,  in  nearly  every 
other  form,  except  navicular  arthritis,  there  will  be  some  appre- 
ciable sign ;  but  in  the  disease  in  question — if  we  except  occa- 
sional heat  and  tenderness  in  the  hollow  of  the  heel,  or  redness 
of  the  frog  and  sole  immediately  below  the  navicular  bursa — 
there  will  be  no  apparent  sign.  The  redness  of  the  frog  and 
sole,  now  and  then  met  with,  is  very  characteristic  when  really 
due  to  navicular  disease ;  but  it  is  not  always  to  be  depended 
upon,  as  it  may  arise  from  external  injury,  such  as  treading 
upon  a  stone,  and  may  be  superficial  only.  Pointing  of  the  foot 
or  feet,  although  a  most  valuable  adjunct  to  a  correct  conclusion 
when  taken  along  with  other  signs,  is  of  itself  quite  insufficient 
to  mark  the  seat  of  the  lameness ;  for  it  may  depend  upon  other 
causes,  such  as  splint,  sprain,  ring-bone,  &c. ;  or  an  animal  may 
point  and  be  perfectly  free  from  any  unsoundness.  This  "  point- 
ing" may  be  a  mere  habit,  or  a  sign  of  fatigue.  In  such 
instances,  however,  it  differs  in  its  character  from  the  pointing 


.  NAVICULAR  DISEASE.  341 

of  lameness.  When  a  mere  habit,  or  arising  from  fatigue,  the 
animal  stands  with  one  fore  foot  and  then  the  other  in  a  semi- 
flexed position,  in  a  careless  lounging  fashion ;  but  he  points  two 
limbs  simultaneously ;  that  is  to  say,  one  fore  and  the  hind  limb 
of  the  opposite  side  of  his  body.  But  in  pointing  from  disease, 
one  foot  only  is  pointed  at  a  time ;  and  when  one  limb  or  foot 
is  diseased,  that  foot  only ;  when  both  fore  feet,  each  foot  alter- 
nately. 

(2.)  The  positive  signs.  If,  along  with  absence  of  other  disease 
in  the  foot  or  limb,  there  be  the  heat  and  tenderness  upon  pres- 
sure at  the  hollow  of  the  heel,  or  the  redness  of  the  sole  already 
spoken  of,  these  may  be  looked  upon  as  positive  signs.  Many 
veterinarians,  by  exercising  great  pressure  upon  the  heel  and 
violently  flexing  the  pastern,  cause  the  horse  to  show  signs  of 
pain,  which  they  consider  sufficient  to  denote  navicular  lame- 
ness ;  but  the  severe  way  in  which  some  make  this  examination 
is  sufficient  of  itself  to  cause  the  pain,  and  even  to  aggravate 
any  other  disease  in  the  limb.  I  have  for  a  long  time  ceased  to 
have  faith  in  this  method  of  manipulation,  and  for  the  reason 
that  many  horses  wdll  wince  upon  pressure,  no  matter  where 
the  lameness  may  exist,  and  content  myself  with  the  action  of 
the  horse,  which  may  be  looked  upon  as  furnishing  the  most 
positive  sign. 

A  horse  suffering  from  this  lameness  comes  out  of  the 
stable  after  an  interval  of  quietude  stiff  and  lame ;  he  may  be 
scarcely  able  to  put  his  lame  foot  to  the  ground,  but  after  he 
has  been  exercised  for  a  short  time,  particularly  if  the  ground 
be  soft,  the  great  lameness  disappears.  If  he  be  lame  in  both 
feet,  his  step  is  short  and  stilty,  and  he  seems  rigid  and 
bound  by  some  stiffness  of  the  muscles  of  the  chest  and 
shoulders.  On  this  account  our  forefathers  called  the  disease 
"chest-founder."  There  is  nothing,  however,  wrong  with  the 
shoulders  or  chest,  and  the  peculiar  rigidity  of  movement  and 
shortness  of  step  are  thus  explained: — Xst.  The  shortness,  be- 
cause the  pain  felt  in  the  foot  implanted  on  the  ground  causes 
the  animal  to  relieve  it  as  soon  as  possible  by  bringing  down 
the  other  foot,  just  as  a  man  lame  in  both  feet  is  compelled  to 
take  short  steps  whilst  walking.  2d.  The  stiffness  arises  from 
an  aversion  to  all  movement  on  the  part  of  the  sufferer,  because 
flexion  of  the  foot  excites  pain  in  the  bursa.     He  also  naturally 


342  DISEASES  OF  THE  FEET. 

avoids  elevating  it  to  any  extent,  from  an  instinctive  know- 
ledge that  the  concussive  shock  would  be  materially  increased 
when  (after  such  elevation)  it  is  again  brought  to  the  ground. 
In  addition  to  shortness  of  step  and  rigidity  of  movement,  the 
wear  of  the  shoes  is  characteristic.  They  are  worn  at  the  toes ; 
the  patient  avoids  bringing  his  heels  down,  and  he  digs  his  toes 
into  the  ground.  Wlien  the  animal  is  lame  in  one  foot  only,  this 
peculiar  appearance  of  the  shoe  is  of  great  assistance  to  correct 
diagnosis. 

Professor  Dick  says  that  "the  S5rrnptoms  of  the  early,  and, 
in  a  practical  point  of  view,  the  most  important  stage  of  the 
disease,  are  a  peculiar  shifting  of  the  feet,  and  a  shortness  of 
the  step ;  while  a  degree  of  heat  is  found  in  the  foot,  more 
especially  about  the  heel  and  coronet.  There  is  a  continual 
pointing  or  holding  of  the  foot  in  a  relaxed  position,  dryness 
of  the  hoof,  throbbing  of  the  plantar  arteries  (?)  and  pain  on 
pressure  in  the  hollow  of  the  pastern.  The  other  parts  of  the 
limbs  are  clean  and  fine ;  there  is  general  tenderness  of  the  foot 
on  pressure,  with  tripping  and  stumbling ;  and  finally,  the  foot  is 
contracted." 

Contraction  of  the  foot  always  succeeds  navicular  disease,  and 
in  some  instances  the  atrophy  is  not  confined  to  the  foot,  but 
extends  to  the  muscles  of  the  shoulders  and  fore  arm.  Tliis 
wasting  has,  however,  no  further  connection  with  the  disease 
than  that  it  results  from  diminished  function,  due  to  limited 
action,  as  already  explained. 

Pathology. — The  parts  involved  are  the  navicular  bone,  the 
articular  cartilage,  the  synovial  membrane  of  the  bursa,  and 
the  tendon  of  the  flexor  pedis  perforans.  The  inflammation 
is  first  limited  to  the  cancelli  of  the  bone,  or  the  cartilage,  as 
illustrated  by  the  following  plates. 

The  tendon  passes  under  the  bone,  as  a  rope  under  a  pulley, 
their  surfaces  being  in  a  more  complete  co-adaptation  from  the 
circumstance  of  the  bone  having  a  process  or  eminence  across 
its  middle,  to  which  the  tendon  is  fitted  by  a  corresponding 
hollow  in  its  substance.  As  a  rule,  it  is  the  crest  of  the 
bone  that  shows  the  earliest  signs  of  caries ;  whilst  calcifica- 
tion of  the  cartilage  is  usually  seen  upon  either  side.  Inflam- 
mation having  been  set  up  in  the  vascular  cancellated  structure 
of  the  bone,  the  progress  of  that  inflammation  may  lead  to  a 


NAVICULAR  DISEASE. 


;43 


variety  of  changes,  both  within  its  interior  and  upon  its  articular 
surface ;  in  one  instance,  to  the  deposition  of  small  calcareous 


Fig.  61  represents  longitudinal  sections  of  four  navicular  bones,  sawn 
through  their  middle  as  near  as  possible. 

1.  Healthy  bone.  CancelU  in  their  natural  condition,  with  distinct 
spaces  (areolae)  between  the  bony  trabeculae. 

2.  Early  stage  of  ostitis.  The,  bone  presents  almost  an  ivory-like 
appearance,  from  exudation  (and  ossification  of  the  exudate)  into  the 
areolar  spaces,  rendering  the  bone  almost  solid. 

3.  Second  stage.  'Showing  rarefaction  of  the  bony  tissue,  and  expan- 
sion of  the  areohe  ;  the  inflammatory  new  formation  has  been  absorbed  ; 
the  cancelli  are  enlarged,  and  cavities  are  formed  (indicated  by  the  dark 
spots)  by  absorption  of  the  bony  trabeculae.  The  exterior  of  this  bone 
shows  no  signs  of  disease. 

4.  In  this  figure  both  the  processes,  viz.,  consolidation  and  rarefaction, 
are  going  on.  In  the  centre  and  to  the  left  hand,  dark  spots  (foraminae) 
are  seen,  indicating  the  destructive  (rarefactive)  process ;  whilst  to  the  right, 
and  indeed  almost  surrounding  the  cavities,  the  bone  presents  the  ivory -like 
appearance,  the  natural  areolae  being  filled  with  bony  matter.  2  and  4 
represent  changes  that  are  consonant  with  those  of  rheumatoid  disease. 

spots  upon   and  within   the   cartilage    (see   No.    2,   Fig.   62) ; 


344 


DISEASES  OF  THE  FEET. 


in  another,  to  the  formation  of  large  carious-looking  cavities ; 
exposing  the  vascular  interior  of  the  bone  (see  No.  3,  Fig.  62), 


Fio.  62  represents  external  appearance  of  inferior  articulating  surfaces 
of  four  navicular  bones. 

1.  Apparently  healthy  bone  ;  externally  it  presents  no  appearance  of 
disease.  It  is  carefully  selected  as  typical  of  an  apparently  sound  bone,  its 
cartilage  of  incrustation  being  intact,  and  the  tendon  perfectly  healthy. 
The  animal  from  which  it  was  taken  had  been  lame  from  navicular  disease 
before  its  death.  Its  internal  appearance  is  represented  by  No.  3  in  the 
preceding  illustration. 

2.  Calcification  of  the  artic\ilar  cartilage.  The  calcareous  spots  indi- 
cated by  the  dark  dots  ;  interior  of  this  bone  much  opened  up. 

3.  Caries  of  articular  surface. 

4.  Adhesion  of  tendon  to  the  exposed  cancelli  of  the  bone. 

with  gi-adual  removal  of  the  bone,  its  texture  at  same   time 
becoming  friable,  until  at  last  it  may  become  fractured  by  some 


NAVICULAR  DISEASE.  345 

trivial  accident.  In  other  instances  the  destructive  process  is 
limited  (see  No.  4,  Fig.  61,  page  343)  by  ossification  of  the 
cancellated  spaces  limiting  the  boundaries  of  the  cavities  by 
a  more  or  less  solid  osseous  wall.  Not  only  are  the  natural 
areolae  of  the  interior  structures  solidified,  but  the  vascular  canals 
within  the  trabeculse  are  blocked  up  by  osseous  material,  the  more 
effectually  to  arrest  the  process  of  destruction ;  and  for  the  same 
purpose,  and  to  limit  motion  as  much  as  possible,  the  tendon  be- 
comes adherent  to  the  bone.  This  adhesion  of  the  tendon  occurs 
in  two  ways : — 1st.  Its  fibres  are  lacerated  and  present  loose  ends. 
These  are  imprisoned  by  lymph  thrown  out  from  the  exposed 
interior  of  the  bone,  and  are  united  to  it  by  a  new  connecting 
fibrous  tissue.  2d.  By  the  formation  of  a  false  membrane, 
which  is  very  vascular,  similar  to  that  already  described 
(Goodsir's  false  membrane),  extending  from  the  synovial  fringes, 
both  on  the  inferior  surface  of  the  bone,  and  superior  surface 
of  the  tendon,  creeping  by  slow  degrees  over  the  whole  articu- 
lar surfaces,  destroying  their  smoothness,  and  becoming  a  bond 
of  union  between  them.  In  some  specimens  all  semblance 
to  a  bursa  has  been  destroyed  by  the  parts  becoming  completely 
united  together,  and  secretion  of  synovia,  being  no  longer 
required,  has  entirely  ceased.  In  the  earlier  stages  the  synovial 
secretion  seems  to  be  augmented,  and  this  was  considered  by 
Professor  Dick  to  give  rise  to  the  fulness  which  is  sometimes 
observable  in  the  hollow  of  the  heel.  In  some  rare  instances 
the  navicular  and  pedal  bones  become  anchylosed  by  spicules  of 
bone  from  the  inferior  border  and  extremities  of  the  navicular, 
and  from  the  posterior  part  of  the  pedal  bone. 

The  changes  in  the  tendon  are  indicated  by,  first,  softening 
and  fibrillisation  of  its  superior  surface  ;  the  splitting  up  is  not 
altogether  due  to  friction  against  the  roughened  surface  of  the 
diseased  bone,  but  to  degeneration  of  the  structure  of  the  ten- 
don, from  the  inflammatory  action  having  extended  to  it  from 
the  bone,  and  increased  vascularity  ctf  its  connecting  tissue. 
This  splitting  up  or  rupture  of  the  fibres  is  manifested  by  the 
surface  of  the  tendon  being  covered  by  tufts  of  loose,  stringy, 
whitish  fibres,  with  their  free  extremities  floating  in  the  secre- 
tion of  the  synovial  membrane,  until  an  exudate  is  formed,  by 
which  they  are  at  a  later  stage  united  to  the  bone. 

The  synovial  membrane,  at  a  very  early  stage,  is  involved  in 


346 


DISEASES  OF  THE  FEET. 


the  inflammatory  action ;  its  vessels  are  injected,  its   surface 
presenting  a  red  streaky  appearance;  it  becomes  slightly,  but 


■^•r 


O'- 


Fig.  63.  Fig.  64. 

Fig.  63  shows  the  gradual  ejection  of  the  tissues  of  the  cartilage  at  the  ulcerated 
spots.  In  the  centre  of  the  hollow  the  superficial  parts  of  the  cartilage  have  disap- 
peared, and  the  deeper  parts  are  undergoing  degeneration,  becoming  irregular, 
shrivelled,  losing  their  walls,  and  discharging  their  contents. — (After  Redfern.) 

Fig.  64. — Vertical  section  of  cartilage,  showing  the  notches  produced  by  burst- 
ing of  the  cells,  and  the  fibrous  and  granular  mass  on  the  free  surface. — (Redfern.) 

This  figiure  very  fairly  illustrates  the  change  in  the  navicular  cartilage  at  an 
early  stage  of  its  conversion  into  a  finely  granular  calcareous  substance. 

never  much  thickened;  in  very 
chronic  cases  its  free  surface 
becomes  involved  in  the  gene- 
ral adhesive  process,  and  united 
to  the  tendon  and  bone. 

The  changes  in  the  cartilage 
are  the  same  as  when  the  carti- 
laG^e  of  incrustation  is  inflamed 
in  an  articulation  (see  Chapter 
XI.) ;  it  is  either  removed  from 
the  surface  of  the  bone  by  ulcera- 
tion, or  converted  into  fibrous 
tissue  or  a  calcareous  material. 

The  supposition  that  the  sur- 
FiG.  65  shows  the  superficial  cells  of  faccof  this  cartilage  is  naturally 

the  cartilage  enlarged,  and  passing  into  a  j    ■>  i  • a. 

granular  and  fibrotsmass  on  the  surface.    COVCrcd   by  a  membrane   IS  not 

borne  out  by  microscopic  inves- 
tigation ;  the  supposed  membrane  being  nothing  more  than 
the  cartilage  corpuscles,  which  are  flattened  upon  the  free  sur- 


NAVICULAR  DISEASE.  347 

face  of  all  articular  cartilages. — (See  Fig.  36.)  It  is  true  that 
the  navicular  bone,  like  the  sesamoids  and  the  bicipital  groove 
of  the  humerus,  is  covered  by  a  cartilage  with  fibrous  tissue  im- 
bedded in  its  matrix,  but  there  is  no  membrane  on  the  surface. 

The  phenomena  observable  during  the  course  of  the  disease 
here  call  for  remark,  more  especially  the  variation  in  the  point- 
ing of  the  feet.  One  animal  will  exhibit  this  sign  before  any 
lameness  is  manifested,  whilst  another  will  have  been  lame  for 
some  time  before  it  begins  to  point.  In  the  first  instance,  the 
pain  in  the  part  is  due  to  a  very  slight  degree  of  inflammatory 
action,  and  marks  a  slow,  insidious  development  of  the  disease ; 
there  is  sufficient  pain  to  cause  uneasiness  whilst  the  animal  is  at 
rest,  and  when  his  attention  is  not  called  away  from  it ;  but  when 
at  work,  the  excitement  of  exercise,  more  especially  if  he  be  a 
high-spirited  horse,  makes  him  forget  his  pain,  or  the  pain  itself 
is  dissipated  by  movement.  In  the  other  case,  sufficient  injury 
has  been  inflicted  to  cause  immediate  lameness,  and  this  may 
last  for  some  time  before  the  animal  becomes  habituated 
to  the  method  by  which  some  degree  of  relief  is  secured  by 
pointing.  The  act  of  pointing  is  performed  in  two  ways  : — Ist. 
By  extension  of  the  limb  and  of  the  pastern,  the  heel  of  the  foot, 
resting  upon  the  ground,  the  leg  stretched  forward  before  its 
fellow.  In  this  form  relief  is  obtained  by  the  increased  obliquity 
of  the  pastern,  and  by  an  endeavour  to  approximate  the  column 
of  bones  to  their  natural  position,  whereby  weight  is  taken  off 
the  navicular  bone.  The  other  method  is  by  flexing  the  limb, 
touching  the  ground  with  the  toe  only,  the  heel  elevated, 
the  flexor  aspect  of  the  limb  relaxed,  and  the  inflamed  part 
relieved  of  tension  and  pressure  as  much  as  possible.  This 
form  is  indicative  of  more  advanced  disease  than  the  former,  of 
denudation  of  the  osseous  cancelli,  and  fibrillisation  of  the  tendon. 

The  concavity  of  the  sole  of  the  foot  is  gradually  increased, 
and  the  frog  hardened  and  elevated  from  the  ground,  or  soft- 
ened by  a  discharge  from  its  cleft  and  surface.  These  changes 
are,  however,  but  a  part  of  the  general  atrophy  of  the  foot ;  there 
is  decreased  functional  activity ;  the  heel  is  not  brought  firmly 
to  the  ground,  and  its  structure  wastes  or  becomes  diseased. 

In  discussing  the  causes  of  the  disease,  I  have  stated  my 
opinion  that  generally  the  alteration  in  the  direction  of  the 
bony  column  by  the  shoe,  or  by  a  natural  upright  conformation 


348  DISEASES  OF  THE  FEET. 

of  pastern,  is  the  great  cause.  In  addition  to  this  violent 
interference  with  the  designs  of  nature,  the  elevation  of  the 
heels  furnishes  additional  cause  of  concussion  to  those  already- 
stated,  by  removing  the  frog  from  the  ground ;  the  frog  being 
elastic,  tough,  and  strong,  intended  to  touch  the  ground  and 
diffuse  concussion,  as  well  as  to  prevent  slipping  at  each  step 
the  animal  takes.  When  left  in  its  natural  condition,  it  is  a 
large  tough,  softish  body,  giving  way  to  the  pressure  of  the 
fingers  when  manipulated,  expanding  each  time  the  foot  is  put 
to  the  ground,  the  commissures  at  its  sides  admitting  of  this 
expansion  without  the  other  parts  of  the  foot  being  interfered 
with.  So  long  as  it  touches  the  ground,  the  sensitive  parts 
within,  and  particularly  the  navicular  bursa  for  which  it 
furnishes  a  soft  bed,  rests  upon  a  resilient  body,  free  from 
concussive  danger.  Besides  furnishing  this  soft  bed,  it  per- 
forms another  important  function ;  being  elastic  within  and 
without,  it  assists  the  flexors  in  the  first  act  of  elevating  the 
foot  from  the  ground,  and  it  does  this  in  virtue  of  its  inherent 
power  of  assuming  its  original  shape  when  the  superincumbent 
weight  is  taken  away  from  it.  Thus,  whilst  on  the  ground, 
and  bearing  its  proportion  of  weight,  it  is  flattened  from  side 
to  side,  bulging  into  the  commissures  and  cleft,  ready  at  every 
movement,  like  a  piece  of  india-rubber,  to  assume  its  proper 
form  when  the  least  portion  of  the  weight  is  taken  from  it. 
When  the  flexors  are  acting,  it  becomes  narrowed  from  side 
to  side,  and  deeper  from  surface  to  surface,  and  during  this 
assumption  of  its  natural  form,  it  gives  an  upward  impetus  to 
the  foot,  which  is  of  essential  importance  to  its  easy  elevation. 
The  removal  of  this  frog  pressure  during  long  periods  of  rest  in 
the  stable  is  also  a  fertile  source  of  the  disease,  because  the  frojx 
becomes  hardened,  and  does  not  furnish  a  soft  cushion  for  the 
bursa  to  rest  upon.  The  question  may  be  very  properly  asked, 
Why,  if  concussion  be  the  cause  of  the  disease,  the  caries  does 
not  appear  upon  both  synovial  surfaces  of  the  navicular  bone  ? 
The  answer  to  this  may  be  found  in  the  following  remarks, 
namely — 1st.  That  the  lower  surface  and  tendon  were  intended 
to  rest  upon  the  soft  resilient  frog,  and  not  upon  a  hardened 
body,  like  what  we  find  in  improperly  shod  horses.  2d.  That 
the  changes  of  tissue  consequent  upon  functional  activity  is 
gi'eater  upon  the  sui'face  under  which  the  tendon  plays,     od. 


NAVICULAR  DISEASE.  349 

Ulcers  have  always  a  tendency  to  open  upon  parts  nearest  the 
surface  of  the  body;  and,  finally,  because  this  surface,  being 
deprived  of  its  soft  cushion  (the  frog),  receives  a  greater  amount 
of  concussion. 

Treatment. — Eecollecting  that  the  first  stage  is  that  of  in- 
flammation, all  means  should  be  used  to  arrest  this  process 
before  any  alterations  of  structure  have  taken  place.  Shoes 
are  to  be  removed ;  the  frogs  allowed  to  touch  the  ground ; 
blood  is  to  be  withdrawn  from  the  toe,  or  coronary  plexus  ;  and 
the  feet  placed  in  a  cold  water  bath  for  several  hours  during 
the  day,  and  in  a  poultice  at  night.  Whilst  in  the  bath  the 
horse's  head  must  be  tied  up ;  but  when  he  is  out  of  it  he 
should  be  encouraged  to  lie  down,  for  the  purpose  of  taking 
weight  off  the  feet.  This  method  of  treatment,  with  an  occasional 
purgative  and  a  cooling  diet,  has  proved  most  successful.  At 
the  end  of  a  fortnight,  whether  the  lameness  be  removed  or  not, 
a  mild  blister  round  the  coronet  is  very  useful ;  but  should 
this  plan  prove  of  no  avail,  a  seton  must  be  inserted  through 
the  frog.  If  the  near  foot  is  to  be  operated  upon,  the  needle 
should  be  introduced  from  the  frog  upwards;  but  if^-the  off 
one,  from  the  heel  downwards,  if  the  operator  be  not  left-- 
handed.  It  is  seldom  necessary  to  cast  the  animal.  The  horny 
frog  must  be  well  pared,  and  if  the  needle — a  sharp-pointed, 
short,  curved  one — be  passed  quickly,  the  operation  is  generally 
completed  before  the  animal  knows  much  about  it.  It  is 
necessary  that  care  should  be  taken  not  to  introduce  the  needle 
too  deeply,  as  the  tendon  may  be  wounded ;  the  point  of  the 
needle  should  be  introduced  into  the  frog  about  one  inch  from 
its  toe,  and  brought  out  midway  between  the  bulbs  of  the 
frog  and  the  anterior  boundary  of  the  hollow  of  the  heel. 
The  ends  of  the  tape  must  be  tied  together,  so  as  to  form  a 
loop,  which  is  to  be  sufficiently  long  to  admit  of  a  little  move- 
ment in  dressing,  but  not  so  long  as  to  extend  to  the  boundary 
of  the  wall,  or  the  horse,  by  treading  upon  it,  will  soon  destroy 
it.  Before  the  seton  is  introduced,  it  is  usual  to  put  on  the 
shoe,  for  the  purpose  of  removing  weight  from  the  irritated 
frog.  About  three  weeks  or  a  month  is  the  usual  time  for 
keeping  the  seton  in  the  frog,  dressing  it  daily,  and  keeping 
the  foot  clean.  After  its  removal,  the  frog  must  be  examined, 
for  usually   it   is   "  under-run "   between   the   two  orifices   by 


350  DISEASES  OF  THE  FEET. 

purulent  matter ;  if  such  be  the  case,  the  detached  hom  must 
be  removed,  and  the  exposed  parts  dressed  with  a  little  tar.  If 
structural  changes  have  not  taken  place,  this  plan  of  treatment 
will  usually  be  found  effective ;  but  if  the  lameness  continue 
after  a  month  has  elapsed  after  the  removal  of  the  seton,  all 
treatment  will  be  useless,  and  the  animal  should  be  put  to  slow 
work,  or  the  pain  removed  by  neurotomy. 

This  operation  (neurotomy)  is  a  very  simple  one,  if  care  be 
taken.  The  incisions  ought  always  to  be  made  in  the  hollows 
immediately  above  the  sides  of  the  fetlock- joint,  in  order  that 
the  inner  cicatrix  be  protected  from  injury  from  the  opposite 
foot.  Two  methods  of  procedure  were  recommended  by  Pro- 
fessor Sewell  and  others,  namely,  to  perform  above  the  fetlock, 
called  the  "  high  operation,"  or  below  it,  called  the  "  low 
operation."  The  high  operation  includes  the  division  of  the 
trunks  of  the  plantar  nerves ;  and  the  low,  the  division  of  their 
posterior  branches  only.  Had  success  attended  the  latter 
method,  it  would  have  been  the  more  satisfactory  plan ;  but 
unfortunately  it  does  not  entirely  remove  the  lameness. 

To  operate  successfully,  the  following  rules  must  be  followed : 
— 1st.  Clip  the  hair  finely  over  the  course  of  the  nerve,  that 
is,  immediately  anterior  to  the  anterior  border  of  the  perforans 
tendon.  2d.  Let  the  animal  be  made  to  stand  in  cold  water 
for  an  hour  before  operating;  this  lessens  the  tendency  to 
haemorrhage  from  the  small  vessels  necessarily  cut  through. 
od.  Cast  the  animal  carefully.  The  leg  to  be  operated  upon 
must  be  removed  from  the  hobble,  but  fastened  to  the  hind 
leg  by  the  side-line  extended  from  above  the  knee  to  the  thigh ; 
the  foot  pulled  forward  by  a  cord  or  strap  tied  round  it,  and 
held  by  an  assistant.  It  is  necessary  to  extend  the  fetlock- 
joint,  or  the  incision  might  be  accidentally  carried  into  the 
sesamoid  bursa.  Mh.  Feel  for  the  edge  of  the  tendon,  and  cut 
boldly  but  carefully  down  upon  the  nerve,  exposing  it  without 
dissecting  the  areolar  tissue,  hth.  Divide  the  nerve  as  higli 
up  as  the  incision  will  admit,  in  order  that  the  skin  may  over- 
lap its  exposed  extremity,  and  dissect  out  at  least  an  inch  of 
its  length.  The  nerve  is  always  divided  at  the  superior  part 
of  the  wound,  in  order  that  the  infliction  of  pain  be  not 
repeated,  as  would  be  the  case  if  the  first  division  were  made 
below,     ^th.  When  the  nerve  is  removed,  the  lips  of  the  wound 


NAVICULAR  DISEASE.  351 

may  be  brought  together  by  suture,  pin,  or  bandage,  the  latter 
being  preferable,  as  leaving  less  blemish.  It  is  usual,  when 
both  legs  are  to  be  operated  upon,  to  perform  the  operation  on 
the  one  lying  undermost,  of  course  dividing  the  inner  nerve, 
and  upon  the  outer  side  of  the  upper  leg,  before  turning  the 
animal.  When  the  operation  is  completed,  the  patient  is 
allowed  to  rise,  removed  to  the  stable,  and  there  tied,  so  that 
he  cannot  lie  down  or  interfere  with  the  wovmds  for  three  or 
four  days.  If  pins  or  sutures  have  been  inserted,  a  covering 
of  styptic  colloid  or  collodion  may  be  applied  after  the  slight 
haemorrhage  has  ceased ;  after  this  is  done,  if  the  parts  are  not 
interfered  with,  it  will  be  found  that  they  will  unite  by  the 
adhesive  process. 

Unfavourable  results  of  the  Operation. — These  are  many,  even 
in  well-selected  cases.  If  the  selections  are  not  judicious,  the 
operation  is  calculated  to  do  much  harm,  and  to  bring  discredit 
upon  the  practitioner. 

In  determining  whether  it  is  judicious  to  operate  or  not, 
the  following  rules  must  be  borne  in  mind:— Is^.  Never 
operate  on  a  very  heavy,  thick-legged  cart-horse :  2d.  Never 
operate  where  the  feet  are  thin,  weak  in  the  heels,  full  in  the 
sole,  or  otherwise  exhibiting  a  predisposition  to  laminitis  ;  and  M. 
Operate  only  where  the  foot  is  good  and  strong,  the  animal's 
action  not  too  high,  and  the  lameness  otherwise  incurable. 

The  untoward  results  are  fracture  of  the  navicular  bone, 
rupture  of  the  tendon,  sloughing  of  the  hoof,  and  a  peculiar 
gelatinous  degeneration  of  the  bursa,  tendon,  and  surrounding 
structures,  along  with  the  formation  of  a  large  quantity  of  a  low 
form  of  fibrous  tissue. 

The  first  symptom  of  this  degenerative  process  is  a  bulging, 
doughy,  or  elastic  swelling  in  the  hollow  of  the  heel ;  the  ani- 
mal at  the  same  time  going  upon  the  heel  more  than  usual, 
and  the  toe  slightly  elevated  at  every  step  it  takes.  This 
peculiarity  of  gait  may  at  first  be  so  slight  as  almost  to  escape 
notice;  but  it  is  a  symptom  of  importance,  and  should  be 
carefully  noted,  since  it  indicates  that  the  tendon  and  the 
other  structures  are  losing  their  cohesion,  becoming  soft,  and 
more  or  less  extensible.  The  external  swelling  increases, 
until  it  surrounds  the  whole  of  the  coronet,  and  extends  up- 
wards  to  the   fetlock-joint.      The  divided   extremities  of  the 


352 


DISEASES  OF  THE  FEET. 


nerves  frequently  becoming 


Fig,  66. — OflFfore  leg  after  neuro- 
tomy, showing  external  appearance 
of  gelatinous  degeneration  of  its 
structures,  with  rupture  of  the  flexor 
tendon  and  inferior  navicular  liga- 
ment, and  fracture  of  navicular  bone. 


at  the  same  time  very  sensitive 
to  the  touch,  from  a  deposition 
between  their  fibres;  lameness 
may  arise  from  this  cause,  or  it 
may  be  absent.  As  the  swelling 
increases,  the  coronet  and  pastern 
present  a  tense  glistening  appear- 
ance, and  the  elevation  of  the  toe 
becomes  greater  by  degrees,  or 
suddenly,  from  rupture  of  the  ten- 
don; the  leg  assumes  a  form 
similar  to  the  annexed  figure. 

The  condition  illustrated  by  the 
woodcut  (Fig.  66)  is  similar  to 
what  surgeons  denominate  gela- 
tinous degeneration,  or  strumous 
disease  of  the  joints;  and  for  the 
purpose  of  comparison,  I  give  a 
description  of  the  examination  of 
the  leg  from  which  the  woodcut  was 
drawn,  and  the  pathological  condi- 
tion of  a  joint  subject  to  a  similar 
disease  in  the  human  subject. 


(l.)  PATHOLOGICAL  APPEARAXCES  OF  THE  NAVICULAR- JOINT  AND 
SURROUNDING  STRUCTURES  OF  THE  FOOT  REPRESENTED  IN 
FIG.  66. 

External  Appearances. — In  the  space  usually  denominated  the 
pit  of  the  heel,  but  which  now,  owing  to  the  altered  position  of 
the  foot,  constituted  its  posterior  part,  there  was  a  prominent 
bulging  or  elastic  doughy  swelling.  On  removing  the  skin,  exten- 
sive deposits  of  a  gelatinous  or  fibrinous  material  w^ere  revealed 
surrounding  the  pastern  and  fetlock  joints,  involving  the  extensor 
and  flexor  tendons,  forming  a  soft  cushion  for  the  lacerated  struc- 
tures to  rest  upon,  and  embracing  in  its  interstices  a  large  quan- 
tity of  a  sero-sanguineous  fluid. 

The  flexor  perforans  had  been  ruptured  at  that  portion  which 
passes  under  the  navicular  bone ;  but  the  rupture  was  not  com- 
plete, the  inferior  layer  of  fibres  remaining  still  unbroken.     The 


NAVICULAK  DISEASE.  353 

divided  ends  of  the  tendon  were  some  distance  apart,  and  they 
bore  a  jagged  appearance,  owing  to  the  formation  of  fringe-like 
processes  of  a  gelatinous  material,  containing  some  blood-vessels, 
which  gave  to  the  new  formation  an  appearance  similar  to  that 
of  pale  muscular  tissue.  The  inner  or  anterior  surface  of  the 
tendon  bore  evident  traces  of  ulceration  and  gelatinisation ;  and 
it  had  an  appearance  of  ecchymosis  in  its  structure. 

The  inferior  broad  navicular  ligament  was  ruptured,  its  divided 
edges  presenting  the  same  appearances  as  those  of  the  tendon, 
but  were  considerably  more  vascular. 

Appearances  of  the  Navicular  Bone. — Externally,  its  postero- 
inferior  surface  presented  no  distinct  traces  of  ulceration ;  the 
cartilage  was  absorbed ;  and  the  bone  presented  a  vascular  dirty- 
brown  appearance,  and  its  articular  cartilage  was  covered  over  by 
a  vascular  membrane,  the  processes  of  which  could  be  distinctly 
seen  penetrating  the  structure  of  the  bone,  and  extending  over 
more  than  one-third  of  the  bursal  surface.  The  bone  was  frac- 
tured at  about  half  an  inch  from  its  right  extremity. 

(ll.)   PATHOLOGICAL  ANATOMY  OF   GELATINOUS   DEGENERATION,   OR 
STRUMOUS  DISEASE  OF  THE  JOINTS,  IN  THE  HUMAN  BEING. 

"  Gelatinous  degeneration  may  attack  any  joint  in  the  body, 
but  those  most  frequently  affected  are  the  knee,  elbow,  and 
ankle.  I  shall  take  the  knee-joint  as  an  illustration,  as  the 
disease,  especially  that  of  the  low  chronic  form,  is  most  fre- 
quently there  situated. 

"  In  about  six  weeks  after  the  commencement  of  the  disease, 
a  partial  swelling  is  found  on  either  side  of  the  patella,  extend- 
ing towards  the  posterior  aspect  of  the  lateral  ligaments.  This 
increases  around  the  patella,  and  the  markings  of  the  bone  are 
gradually  lost  in  it.  The  swelling  presents  either  a  peculiar 
elastic  or  a  doughy  feel.  As  the  disease  goes  on,  the  symptoms 
become  more  marked,  the  colourless  swelling  increases,  the  joint 
becomes  more  tense,  and  has  a  glazed  appearance. 

"  The  pathological  condition  leading  to  these  symptoms  con- 
sists in  a  peculiar  degeneration  of  the  synovial  membrane. 
This  exists  under  two  forms,  and  these  have  been  described 
under  two  separate  names — the  gelatinous  and  pulpy  degenera- 
tion: but  they  are  truly  identical  in  symptoms,  and  as  regaras 

2  a 


354  DISEASES  OF  THE  FEET. 

the  essential  nature  and  course  of  the  disease.  In  the  gelatinous 
degeneration,  all  the  cartilages  of  incrustation  become  gradually 
covered  over  by  masses  of  new  deposition,  which  extend  wher- 
ever there  is  a  synovial  membrane.  In  the  recent  state,  this 
deposit  has  a  gluey  or  jelly-like  character  varying  in  colour 
from  pale  yellow  to  dark  brown,  and  is  generally  intersected  by 
lines  of  white  membraneous  structure.  This  is  the  more  general 
character  of  gelatinous  disease ;  but  there  is  another  condition, 
in  which  the  membrane  assumes  a  sort  of  granular  or  fungoid 
appearance  on  the  surface.  This  has  been  described  as  pulpy 
degeneration;  but  all  the  phenomena  are  the  same  as  in  the 
former  case,  and  there  is  no  use  in  making  a  distinction  between 
the  two  conditions.  The  deposit  fills  up  the  whole  joint,  and 
acts  as  a  kind  of  soft  cushion,  protecting  the  ends  of  the  bones, 
so  that  at  first,  when  the  swelling  is  most  marked,  there  is  com- 
paratively little  pain. 

"The  cartilage  of  incrustation  is  removed  by  absorption;  the 
absorption  is  induced  by  the  pressure  of  the  new  material  on  its 
surface,  or  by  a  peculiar  action  which  the  deposited  substance 
exerts  upon  the  cartilage.  All  the  textures  are  ultimately  in- 
volved ;  not  only  the  synovial  membrane  and  the  cartilage,  but 
also  the  fibrous  textures  and  the  areolar  tissue.  This  gives  rise 
to  disorganization,  and  the  formation  of  abscesses  and  sinuses  in 
all  directions." — (Spence's  Lectures  on  Surgery.) 

My  object  in  describing  this  comparison  between  the  white 
swelling  of  the  human  joints  and  the  disorganization  that  so 
frequently  succeeds  neurotomy,  is  to  show  how  a  similar  patho- 
logical condition  may  be  induced  by  a  circumstance  which  at 
first  seems  to  be  so  very  dissimilar; — in  the  human  being,  a 
constitutional  taint ;  in  the  horse,  removal  of  a  portion  of  the 
sentient  nerve.  Further  inquiry  may  discover  that  the  disease 
from  constitutional  taint  is  in  reality  due  to  altered  innervation 
consequent  upon  that  taint. 

The  rupture  of  the  tendon  is  due  to  a  slow  degenerative  pro- 
cess, and  not  to  a  sudden  snapping  of  its  fibres,  as  was  formerly 
taught. 

Now  and  then,  however,  sudden  rupture  of  the  tendon  takes 
place  immediately  after  the  operation ;  but  this  is  rare  in  com- 
parison with  the  degenerative  process,  which  not  only  involves 
the  tendon,  navicular  bone  and  ligaments,  but  aU  the  surround- 
ing structures  of  the  foot  and  pastern. 


GELATINOUS  DEGENERATION.  355 

In  the  dissection  of  the  foot  from  which  the  figure  was  drawn, 
the  navicular  bone  was  fractured,  and  the  inferior  broad  liga- 
ment ruptured.  Neither  of  these  results  was  due  to  violence, 
for  the  animal  had  been  at  rest  for  several  weeks  prior  to  its 
death,  and  the  various  changes  had  come  on  gradually. 

Another  unfavourable  result  of  the  operation  is  loss  of  the 
hoof  from  suppuration  induced  by  accidental  injuries  to  the  foot, 
or  from  morbid  action  in  the  tissues,  deprived  of  their  nervous 
sensibility. 

In  some  cases  regeneration  of  the  nerve  substance  occurs ;  the 
divided  ends  become  continuous  by  growth  from  their  extremi- 
ties, the  nervous  current  is  re-established,  and  the  lameness 
recurs.  These  results,  however,  do  not  take  place  for  at  least 
two  years  after  the  operation  is  performed.  If  the  lameness  is 
severe,  it  may  be  necessary  to  excise  the  reunited  nerves,  and 
thus  again  destroy  the  sentient  communication  between  the 
diseased  part  and  the  nervous  centres.  It  has  been  already 
shown  that  fracture  of  the  navicular  bone,  when  unaccompanied 
by  degenerative  disease  of  the  bursa  and  tendon,  may  not  inter- 
fere with  the  animal's  usefulness ;  the  fractures,  as  in  Figs.  15 
and  16,  being  united  by  a  false  joint,  and  the  animal  continuing 
to  perform  his  daily  task  with  apparent  ease  and  comfort. 

My  experience  leads  me  to  the  conclusion  that  the  lameness 
arising  from  ring-bones  or  side-bones,  when  the  feet  are  good 
and  strong,  is  generally  permanently  benefited  by  neurotomy, 
the  animal  restored  to  its  full  usefulness,  and  remaining  sound 
for  many  years.  Indeed,  in  ring-bone  lameness  I  have  repeatedly 
noticed  that  not  only  has  the  lameness  been  entirely  cured,  but 
that  there  has  been  a  gradual  absorption  of  the  osseous  new 
formation,  and  a  restoration  of  the  pastern  almost  to  its  natural 
shape  and  dimensions.  When  the  operation  has  been  performed 
for  the  relief  of  these  lamenesses,  there  appears  to  be  an  absence 
of  any  tendency  to  gelatinous  degeneration  or  other  alteration  of 
structure. 


CHAPTER  XIX. 

DISEASES  OF  THE  FEET — Continued. 

INFLAMMATION  OF  THE  FEET — DIVISIONS  OF  LAMINITIS PATHOLOGICAL 

CHANGES  —  CAUSES  —  SYMPTOMS TREATMENT  —  MR.    BROAD'S 

TREATMENT. 

LAMINITIS,  OR  INFLAMMATION  OF  THE  FEET. 

Inflammation  of  the  feet,  independent  of  its  subdivisions  into 
acute,  subacute,  and  chronic,  is  of  two  kinds,  namely,  inflam- 
mation primarily  limited  to  the  sensitive  laminae  and  sensi- 
tive sole ;  and  ostitis,  or  inflammation  involving  the  os  pedis, 
laminae,  and  sole,  from  the  very  outset.  The  causes,  course, 
and  tractability  of  the  two  forms  differ ;  but  the  first,  if  not  > 
subdued  in  a  short  time,  is  apt  to  become  developed  into  the 
latter. 

"  Laminitis  is  one  of  the  most  dreadful  diseases  the  horse  is 
liable  to,  and  is  not  confined  to  the  feet,  although  its  chief 
seat  is  there.  It  is  caused  by  over-exertion,  inordinate  feed- 
ing, drinking  cold  water  when  heated,  long  voyages,  from  the 
horse  being  compelled  to  stand  in  a  constrained  position,  or  a 
sudden  chill.  It  is  often  communicated  to  the  feet  from  inter- 
nal organs,  as  from  pneumonia,  enteritis  or  bronchitis ;  in  this 
case  the  feet  are  affected  as  well  as  the  whole  surface  of  the 
body,  the  hair  of  the  mane  and  tail  being  often  thrown  off, 
and  the  tendency  of  laminitis  is  to  throw  off  tlie  hoof,  as  well 
as  the  common  integuments,  in  consequence  of  the  general 
irritation." — (Professor  Dick.) 

Laminitis,  arising  from  over-exertion  and  from  the  con- 
cussion of  hard  galloping  on  the  road,  as  in  those  reprehensible 
cases  where  horses  are  run  against  time,  is  much  more  intract- 
able than  when  it  appears  during  diseases  of  the  mucous 
membranes,  when  it  may  pass  off  as  a  mere  congestive  attack. 


LAMINITIS.  357 

without  leaving  any  structural  change ;  whilst  the  form  caused 
by  concussion  leads  to  ostitis  of  the  most  acute  kind,  sometimes 
terminating  in  necrosis  of  the  pedal  bone,  sloughing  of  the  hoof, 
and  a  most  agonising  death.  The  symptoms  of  both  varieties 
are  identical,  except  in  their  severity,  and  if  the  so-called  meta- 
static form  continues  long  enough,  the  pathological  changes  are 
the  same  also. 

Pathology. — Inflammation  of  the  sensitive  foot,  including 
laminae,  sole,  and  os  pedis.  The  exudation  is  greatest  at  the 
toe,  the  foot  being  most  vascular  at  this  point.  The  pain  of 
laminitis  is  most  agonising  and  persistent,  because  the  sensitive 
foot  is  invested  with  an  unyielding  horny  box  pressing  upon  the 
engorged  blood-vessels,  preventing  free  exudation  and  swelling, 
and  thus  proving  a  barrier  to  tlie  method  by  which  congested 
blood-vessels  are  relieved.  The  exudate  in  laminitis  is  found 
to  limit  itself  to  the  external  surfaces  of  the  sensitive  laminse, 
but  in  that  form  caused  by  violent  concussion,  and  which  with 
propriety  might  be  termed  "peditis,"  the  exudation  may  be 
subperiosteal,  detaching  the  periosteum  from  the  pedal  bone 
by  the  outpouring  of  an  unhealthy,  broken-down,  dirty  reddish 
coloured  fluid  ;  whilst  the  interstices  of  the  bone,  its  canals,  and 
lacunse  are  filled  with  the  same  material,  forming  a  barrier  to  the 
free  circulation  of  the  blood,  and  thus  assist  in  hastening  the 
process  of  necrosis  and  sloughing. 

Mere  laminitis  may  pass  off  without  causing  structural 
change ;  there  is  but  a  slight  exudate,  and  this  is  soon  absorbed 
after  the  subsidence  of  the  inflammatory  action.  In  some 
cases  the  removal  of  the  exudate  leaves  a  space  between  the 
sensitive  and  horny  laminae,  which  has  led  some  observers  to 
think  that  the  disease  consists  essentially  of  absorption  of  the 
bond  of  union  between  the  two  sets  of  laminae,  the  formation 
of  a  cavity,  and  the  subsequent  filling  up  of  it  with  imperfect 
cheesy  or  seedy  horn,  constituting  what  is  termed  seedy-toe. 

Should  the  inflammation  persist,  the  exudate  accumulates  at 
the  toe,  increases  in  thickness,  presses  upon  the  toe  of  the  os 
pedis  in  the  one  direction,  and  upon  the  crust  in  the  other, 
separating  the  tw^o,  forcing  the  toe  of  the  bone  downwards,  and 
the  toe  of  the  crust  upwards.  The  effect  of  this  change  in  the 
position  of  the  bone  is  the  formation  of  a  convex  sole.  The 
sole  being  pressed  upon   by  the  point   of  the  bone,  is  forced 


358 


DISEASES  OF  THE  FEET, 


downwards,  losing  its  natural  concave  shape ;  whilst  from  the 
secretory  powers  of  the  sensitive  sole  becoming  interfered  with, 
partly  arrested  or  perverted,  the  horny  sole  remains  thin,  weak. 


Pig  6: 


Fig.  68. 
Fir,.    67  represents  a  section  of   the    foot  with  its  variotis  parts  in  a  healthy 
condition,  and  in  their  proper  relative  positions. 

Fig,  68. — Formation  of  a  homy  exudate  at  the  toe,  causing  alteration  in  the 
several  positions  of  the  os  pedis,  wall  and  sole,  and  the  formation  of  convex  or 
"  pumiced  "  sole.  Whilst  this  process  is  going  on,  the  extensor  pedis  is  elongated, 
and  the  flexors  thrown  into  a  passive  condition. 

cheesy,  or  spongy,  like  macerated  horn,  or  even  gnimons,  afford- 
ing but  little  protection  to  the  sensitive  parts  within.  The  outer 
horn  of  the  wall,  namely,  that  secreted  by  the  coronary  band. 


LAMINITIS. 


359 


now  presents  characteristic  appearances ;  it  becomes  rihhed,  as 
if  there  were  successive  efforts  to  cast  the  hoofs.  The  rings  of 
laminitis  are  irregular,  and  run  together  towards  the  anterior 
aspect  of  the  foot,  as  in  the  annexed  illustration  (Fig.  69).    This 


Fig.  69. 


distinguishes  them  from  the  rings  of  a  healthy  unrasped  foot, 
in  which  they  are  regular,  and  have  wider  interspaces. 

The    bone,    pressed    downwards    by   the    exudate,    becomes 
absorbed  at  its  borders,  by  which  it  is  reduced  in  bulk,  more 


Fig.  70. — Absorption  of  inferior  edge  of  os  pedis,  a, 
Anterior  aspect,  b,  Plantar  edge  ;  the  dark  shade  repre- 
sents a  holloAv  space  from  which  the  bone  has  been  absorbed, 
c,  Basilar  process,     d,  Pyramidal  process. 

particularly  at  its  toe   and  sides,  whilst   its   whole   structure 
becomes  brittle  (1st.)  by  ossification  of  the  exudate  within  its 


360  DISEASES  OF  THE  FEET. 

interstices;  and   {2d.)   by  removal  or  absorption,   as   already 
described  under  Navicular  Disease. 

In  addition  to  the  results  indicated  by  the  above-described 
pathological  changes,  ossification  of  the  sensitive  laminee  and 


Fig.  71  represents  a  more  advanced  atrophied  or  absorbed 
condition  of  the  bone,  with  ossification  of  the  laminae. 

suppuration  are  occasionally  found,  the  latter  occurring  more 
especially  at  the  coronet,  detaching  a  small  portion  of  the  upper 
part  of  the  wall ;  whilst  in  other  instances  a  serous  fluid  collects 
between  the  sensitive  and  horny  soles  and  frogs,  and  detaches 
them  from  each  other. 

Direct  concussion  causes  laminitis,  by  its  effects  upon  all  the 
structures  of  the  feet.  Usually  this  form  is  confined  to  the  two 
fore  feet.  But  we  must  look  further  into  the  question,  to  under- 
stand the  operation  of  inflammation,  or  even  irritation  of  an 
internal  organ,  in  the  causation  of  this  disease. 

Many  writers  state  that  affections  of  a  serous  membrane, 
such  as  the  pleura,  terminate,  by  metastasis,  in  laminitis.  I 
have  carefully  studied  the  question  for  some  years,  and  have 
arrived  at  the  conclusion  that  such  is  not  the  case ;  that  when 
the  feet  become  inflamed  during  the  progress  of  another  disease, 
a  mucous  membrane  is  involved,  and  that  the  inflammation  of 
the  laminae  is  due  to  an  extension  of  the  irritation  from  its 
primary  seat  to  the  laminae  of  the  feet,  as  explained  by  Professor 
Dick  in  the  words  already  quoted,  namely,  "  The  feet  are 
affected,  as  well  as  the  whole  surface  of  tlie  body,  the  hair  of 
the  mane  and  tail  being  often  thrown  off."  To  explain  this, 
it  will  be  necessary  to  remember  that  the  skin,  mucous  structures. 
and  laminje  are  continuous  one  with  another,  and  secretory ; 
the  nature  of  their  secretions  being  similar,  namely,  epithelium 


LAMINITIS.  361 

secreted  by  the  mucous  membranes  ;  scales  of  the  same  nature, 
by  the  skin ;  and  horn  cells,  similar  in  every  respect  to  those  of 
the  skin  and  mucous  membranes,  by  the  laminae.  It  must  also 
be  remembered  that  when  a  part  only  is  irritated,  the  effects  of 
such  irritation  tend  to  spread,  and  that  when  the  mucous  mem- 
branes of  the  intestinal,  uterine,  or  respiratory  passages  are 
inflamed,  the  skin  participates,  as  may  be  witnessed  in  many 
cases  of  cutaneous  eruption  from  indigestion,  catarrh,  &c.  The 
irritation  of  the  cutaneous  surface  may  be  very  slight,  scarcely 
observable ;  but  the  irritation  of  its  foldings  in  the  feet,  sur- 
rounded by  their  unyielding  case,  becomes  a  source  of  great 
pain;  in  fact,  it  may  be  said  that  this  slight  sympathetic 
irritation  becomes  the  cause  of  an  acute  inflammation,  because 
located  in  unyielding  structures.  I  am  convinced  there  is  no 
real  metastatic  transference  of  the  inflammation  from  its  original 
seat,  for  it  is  found,  when  horses  die  from  super-purgation, 
diarrhoea,  or  other  irritation  of  the  intestinal  mucous  membrane, 
that  laminitis  is  often  present  before  death,  and  post  mortem 
examinations  of  such  reveal  the  presence  of  inflammation,  both 
in  the  feet  and  in  its  original  seat.  It  is  not  necessary  to  have 
an  inflammatory  disease  of  mucous  tissue  to  induce  fever  in 
the  feet ;  a  slight  irritation,  such  as  that  of  a  moderate  cathartic, 
being  sufficient.  I  have  several  cases  on  record  where  a 
moderate  dose  of  purgative  medicine  has  caused  inflammation 
of  the  feet,  without  seemingly  stimulating  the  intestines  to 
more  than  moderate  purgation.  That  the  skin  is  in  an  irritable 
condition  is  also  proved  by  the  tendency  to  the  non-healing  of 
w^ounds  during  laminitis,  by  the  loss  of  hair,  as  pointed  out 
by  Professor  Dick,  and  by  the  frequent  occurrence  of  phlebitis, 
or  inflammation  of  the  jugular  vein  after  bleeding  from  it  in 
this  disease.  The  wound  in  tlie  skin  made  for  the  withdrawal 
of  blood  does  not  heal,  but  suppurates,  and  the  diseased  process 
extends  to  the  venous  coats. 

Acute  laminitis  terminates  in  resolution  of  the  parts,  or  in 
that  form  w^hich  is  termed  subacute  or  chronic,  in  suppuration, 
and  occasionally  in  gangrene. 

Chronic  laminitis  is  that  condition  of  the  feet  remaining 
after  the  subsidence  of  the  febrile  symptoms ;  or  it  may 
originate  independently  of  an  acute  attack.  Horses  suffering 
from  the  chronic  form  are,  however,  subject  to  the  acute  from 


362  DISEASES  OF  THE  FEET. 

the  most  trivial  causes  ;  and  tlie  acute  form,  when  caused  hy 
concussion,  if  the  animal  outlive  the  primary  attack,  commonly 
degenerates  into  the  chronic.  The  pathological  changes,  namely, 
the  descent  of  the  toe  of  the  pedal  bone,  the  absorption  of  its 
borders,  formation  of  convex  and  weak  sole,  and  the  organiza- 
tion of  a  large  mass  of  imperfect  horn  at  the  toe,  are  identical 
in  both  forms,  the  difference  being  in  the  severity  of  the 
accompanying  febrile  disturbance,  and  in  the  time  in  which 
the  changes  are  accomplished. 

The  predisposition  to  inflammation  of  the  feet  is  often  trace- 
able to  hereditary  tendency  and  defective  conformation,  as  well 
as  to  bad  manasjement  of  the  feet.  It  is  said  that  horses  with 
wide  feet  are  more  liable  to  the  disease  than  others.  Such  is 
not  my  experience.  Indeed,  it  cannot  be  said  that  any  one 
shape  of  foot  is  more  susceptible  than  another.  It  is  more 
commonly  found  in  heavy  dray-horses  than  in  those  of  a  lighter 
breed,  this  being  doubtless  due  to  the  great  weight  the  feet  of 
such  are  compelled  to  bear,  weakened,  as  they  often  are,  by 
paring  of  the  sole. 

There  are  two  other  classes  of  horses  which  are  very  liable 
to  the  disease  : — (1st.)  The  horse  which  has  overgrown  his  breed, 
that  is  to  say,  an  animal  with  the  legs  and  feet  of  a  well-bred 
and  the  body  of  a  cart-horse;  (2d.)  Small  ponies  that  are 
excessively  fat.  In  both  these  instances  the  inflammation  can 
only  be  attributed  to  the  unnatural  weight  of  the  body  being 
greater  than  the  feet  are  able  to  bear.  I  feel  satisfied,  however, 
although  the  weight  predisposes,  that  the  removal  of  the  solar 
horn  is  the  exciting  cause.  When  horse-shoers  learn  to  discard 
the  drawing-knife,  laminitis,  except  from  other  clearly  defined 
causes,  will  be  much  rarer  than  at  present. 

The  more  immediately  exciting  causes  are  concussion,  excite- 
ment, over-exertion,  indigestion,  more  especially  when  caused 
by  engorgement  of  the  stomach  with  wheat,  or  any  other  cause 
of  intestinal  irritation ;  bad  shoeing,  paring  of  the  feet,  tight 
nailing  of  the  shoes,  and  high  calkins. 

Generally,  the  disease  is  confined  to  the  two  fore  feet, 
especially  when  caused  by  concussion;  but  it  is  not  very 
unusual  to  find  all  the  four  feet  affected ;  sometimes  the  hind 
feet  only,  and,  in  rare  instances,  one  fore  or  one  hind  foot. 
AVhen  one  foot  only  is  affected,  it  is  due  to  an  injury  to  the 


LAMINITIS.  363 

opposite  foot  or  limb,  which  compels  the  animal  to  throw  all 
the  weight  of  that  part  of  his  body  upon  the  sound  side.  The 
sound  foot  becomes  inflamed,  which  is  indicated  by  lameness, 
heat,  and  pain.  Premonitory  to  the  advent  of  the  disease  in 
the  sound  foot,  the  patient  will  sometimes  suddenly  be  seen 
to  bear  his  weight  upon  the  originally  lame  side,  although  the 
wound,  open  joint,  or  other  injury  from  which  he  may  be 
suffering,  continues  in  all  its  severity.  An  ordinary  observer 
will  consider  the  animal  to  have  been  unexpectedly  relieved 
of  pain ;  but  in  a  short  space  of  time  the  hitherto  sound  foot 
will  be  elevated  from  the  ground,  the  animal  at  the  same  time 
evidencing  agonising  pain ;  fever  will  set  in,  and  the  head  will 
be  pushed  into  a  corner.  These  symptoms  are  manifested  to  a 
much  severer  degree  when  a  hind  foot  is  involved.  To  prevent 
this  complication  to  a  severe  injury  or  lameness,  the  shoe  is  to 
be  removed  from  the  sound  foot,  which,  in  very  aggravated 
cases  of  injury,  may  be  placed  in  a  soft  poultice,  or  allowed  to 
stand  upon  some  soft  substance.  The  leg  must  be  bandaged  ; 
and  if  the  horse  is  unable  to  lie  down,  as  will  generally  be  the 
case  when  a  hind  limb  is  involved,  he  must  be  placed  in  slings. 
I  once  saw  a  case  where  the  os  pedis  of  the  off'  hind  foot  had 
been  forced  through  the  horny  sole,  in  consequence  of  the  animal 
having  received  an  injury  to  the  near  hind  leg.  The  animal 
was  young,  and  newly  taken  up  to  be  broken-in.  Through 
some  oversight,  the  horse  was  shod  upon  both  fore  and  the  off' 
hind  feet,  the  near  side  foot,  owing  to  the  lameness  in  the  leg, 
being  left  without  the  shoe.  By  this  error  extra  weight  was 
thrown  upon  the  foot  of  the  sound  limb — thus  elevated  above 
its  fellow  by  the  shoe — which  caused  violent  inflammation,  and 
the  destructive  process  above  mentioned.  The  case  is  very 
instructive. 

Symptoms  of  Inflammation  of  'both  Fore,  Feet. — The  horse  is 
excessively  lame,  almost  immoveable,  especially  at  starting ;  he 
seems  as  if  all  his  body  were  cramped ;  stands  with  his  hind 
legs  drawn  under  the  belly,  and  the  fore  feet  advanced,  in 
order  to  relieve  them  from  the  weight  as  much  as  possible; 
occasionally  he  may  be  seen  to  sway  himself  backwards,  elevat- 
ing the  toes,  throw  his  weight  for  a  moment  upon  the  heels  of 
the  fore  feet,  and  then  assume  his  original  position.  If  com- 
pelled to  move,  he  elevates  his  feet  with  great  difiiculty,  not 


364  DISEASES  OF  THE  FEET. 

because  the  muscles  of  locomotion  are  inflamed,  as  is  sometimes 
supposed,  but  because  he  requires  all  his  feet  to  be  upon  the 
ground  at  the  same  time  to  bear  the  weight  of  the  body.  He 
will  often  groan  from  pain,  while  sweats  bedew  the  skin. 

To  diagnose  a  case  quickly,  the  best  method  is  to  push  the 
horse  backwards,  when  it  will  be  seen  at  once  that  he  will 
elevate  his  toes,  and  throw  his  weight  upon  the  heels.  The 
pulse  of  laminitis  is  full,  strong,  and  accelerated;  and  it  will 
maintain  the  character  of  strength  and  fulness  even  after  general 
debility  has  manifested  itself. 

In  some  instances  the  animal  lies  down  upon  its  side,  with 
the  legs  stretched  out,  for  hours  together,  evidently  feeling  great 
relief  from  the  assumption  of  this  position;  whilst  in  others, 
particularly  during  the  earlier  periods  of  the  disease,  it  will 
stand  persistently. 

When  the  hind  feet  only  are  affected,  the  patient  stands  with 
all  his  four  feet  together ;  the  fore  ones  are  pushed  under  the 
body,  and  not  extended  forwards,  as  when  they  are  inflamed; 
the  hind  ones  are  extended  forwards,  in  order  to  throw  the 
weight  upon  the  heels.  Many,  especially  students,  suppose  that 
when  the  hind  feet  are  inflamed,  the  horse  stands  with  them 
pushed  backwards,  to  remove  them  from  the  centre  of  gravity  as 
far  as  possible.  Such  is  not  the  case,  since  this  position  would 
cause  the  weight  to  be  borne  by  the  toes,  the  part  of  the  feet 
which  he  is  most  careful  to  relieve,  as  it  is  the  very  spot  where 
the  inflammation  is  most  acute.  The  sufferings  of  the  patient 
are  even  greater  when  the  hind  feet  are  aftected,  and  usually 
the  symptoms  become  greatly  aggravated  by  the  standing  pos- 
ture. It  is  distressing  to  witness  so  much  pain;  the  animal 
standing  "  all  of  a  heap,"  with  anxious  eyes ;  now  nervously 
elevating  one  foot  from  the  ground,  then  its  fellow ;  its  respira- 
tions hurried  and  nostrils  dilated,  in  fact,  "blowing,"  as  vulgarly 
expressed ;  when  compelled  to  move,  as  soon  as  the  toes  of  the 
hind  feet  are  pressed  to  the  ground,  he  takes  a  kind  of  a  jump 
forwards,  performing  perhaps  two  or  three  automatic  steps,  from 
the  agony  of  the  pain.  He  rarely  stands  long  when  the  hind 
feet  are  affected,  and  experiences  immediate  relief  when  recum- 
bent. Very  often  the  pulse  will  fall  twenty  or  thirty  beats  in 
the  minute  in  the  course  of  a  quarter  of  an  hour  after  he  has 
assumed  this  position. 


LAMINITIS.  365 

When  all  four  feet  are  affected,  the  symptoms  will  consist  of 
a  combination  of  the  foregoing,  with  local  heat  in  all  the  feet, 
some  degree  of  throbbing  of  the  plantar  arteries,  and  tenderness 
upon  manipulation,  or  to  the  touch  of  the  hammer. 

Treatment. — Gentle  purgatives.  On  no  account  must  violent 
cathartics  be  given,  since  the  operation  of  purgatives  tend  to 
laminitis,  and  they  occasionally  cause  death  when  the  disease 
itself  has  been  of  a  tractable  or  even  mild  form.  If  the  bowels 
are  loaded,  injections  of  warm  water  are  very  serviceable ;  but  if 
the  constipation  is  not  very  urgent,  they  may  be  dispensed  with. 

In  addition  to  a  mild  aperient,  febrifuges  are  to  be  adminis- 
tered ;  and  for  the  fever  of  laminitis  I  know  of  nothing  which 
proves  so  effectual  as  the  tincture  of  aconite,  in  small  but  re- 
peated doses.  In  that  form  arising  from  irritation  of  mucous 
membrane  or  indigestion,  the  bicarbonate  of  soda  may  be  added 
to  the  aconite.  If  the  pain  be  very  severe,  I  think  better 
results  are  obtained  from  opium  or  morphia  than  from  aconite, 
which  seems  to  act  more  by  reducing  fever  than  by  allaying 
pain.  This  method  of  treatment,  with  poultices  to  the  feet,  and 
the  application  of  Mr.  Broad's  shoes,  has  proved  of  eminent 
service  in  the  treatment  of  laminitis. 

Practitioners  differ  in  opinion  as  to  whether  cold  or  warm 
poultices  or  baths  should  be  applied.  Some  recommend 
cold,  others  prefer  warm.  For  my  own  part  I  have  found 
that  pain  and  fever  are  more  speedily  removed  by  warm  fomen- 
tations and  poultices  in  the  early  stages,  and  the  resolution  of 
the  inflammation  is  promoted  by  cold  applications  after  the 
very  urgent  symptoms  have  passed  off.  There  is  no  necessity 
to  discuss  the  why  and  the  wherefore  of  these  two  methods, 
suf&ce  it  that  warmth  has  a  soothing  effect  upon  a  part  to  which 
it  is  applied,  and  that  this  soothing  of  pain  in  laminitis  is  the 
first  essential  step  in  its  treatment. 

Mr.  Broad  strongly  recommends  exercise,  even  in  the  earliest 
stage  of  the  disease,  and  very  urgently  requests  me  to  do  so  also, 
but,  much  as  I  respect  Mr.  Broad,  I  cannot  alter  the  conclusion 
I  have  arrived  at  from  much  experience  of  the  disease  and  its 
treatment.  Mr.  Broad  assures  me  that  he  is  always  successful 
with  exercise.  I  can  only  reiterate  what  I  stated  in  the  first 
edition  of  this  work,  that  I  am  of  opinion  that  Mr.  Broad  would 
even  be  more  successful  than  he  is,  if  he  were  to  abandon  this 


366  DISEASES  OF  THE  FEET. 

portion  of  his  treatment.  If  the  disease  were  a  mechanical 
congestion  of  the  vessels,  doubtless  such  congestion  would  be 
relieved  by  the  motion  of  the  limbs  ;  but  we  must  look  for  some- 
tliing  more  than  congestion  being  the  origin,  namely,  imtation, 
and  to  the  fact  that  congestion  is  the  result  and  not  the  cause  of 
the  disease. 

The  necessity  for  bleeding  in  laminitis  is  a  question  upon  which 
practitioners  differ.  Without  discussing  it,  I  may  state  that  I 
consider  local  bleeding  from  the  coronary  plexus  advantageous, 
relieving  the  congestion  and  alleviating  pain. 

The  treatment  of  laminitis  has  hitherto  been  often  unsatisfac- 
tory ;  but  a  short  time  ago  a  method  was  recommended  by  Mr. 
Broad,  V.S.,  Bath,  which  at  the  time  secured  for  him  a  fair  share 
of  abuse  and  condemnation ;  one  writer  going  so  far  as  to  state 
that  he  thought  the  Society  for  the  Prevention  of  Cruelty  to 
Animals  ought  to  be  informed  about  it.  Fortunately,  however, 
for  Mr.  Broad,  none  of  his  critics  had  ever  tried  the  plan ;  whilst 
others,  less  prejudiced,  and  quite  as  eminent  in  the  profession, 
gave  it  a  trial,  and  were  satisfied  that  it  was  most  successful 
when  properly  applied. 

Mr.  Broad's  Treatment. — Mr.  Broad  has  kindly  written  out 
his  method  of  treatment,  and  I  give  it  here  in  his  own 
words : — 

"TREATMENT  OF  ACUTE  LAMINITIS. 

"  As  early  as  possible  get  lightly  nailed  on  the  feet  affected 
extremely  stout,  wide-webbed,  and  long  bar  shoes,  made  from 
iron  about  twice  the  ordinary  thickness  that  the  particular 
horses'  shoes  are  made  from ;  make  them  gradually  thin  from 
behind  the  quarters,  so  that  the  heel  part  of  the  shoes  is  wide 
and  thin,  and  fitted  rocker  fashion,  which  enables  the  horse  to 
throw  his  weight  where  he  tries  to,  much  better  than  he  can  in 
ordinary  shoes  or  without  any ;  that  is,  off  the  pedal  bone  on 
to  the  soft  elastic  tissues  and  tendon  behind  it,  which  are 
much  less  vascular  and  sensitive. 

"  The  object  of  putting  on  very  stout  shoes  is  to  lessen  the 
jar  as  it  more  commonly  occurs  that  the  horses  are  obliged  to 
be  exercised  on  hard  ground,  as  soft  is  not  obtainable  near. 
(It  is  a  generally  acknowledged  fact  with  practical  men  that 
stout  shoes  lessen  the  jar  to   the  feet  of  horses  working  on 


LAMINITIS.  267 

pitching  or  hard  roads  much  more  than  light  ones  do.)  If  the 
case  is  not  a  severe  one,  plain  shoes,  made  after  the  same 
fashion,  will  do,  although  I  prefer  the  bar  shoes.     I  sometimes 


Fig.  72. — Mr.  Broad's  shoe  as  described  in  the  text. 

use  leather  soles,  but  not  in  all  cases.  If  the  heels  of  the  feet 
are  very  strong  and  high,  lower  them ;  if  not,  don't  cut  or  pare 
the  feet  in  any  way.  I  also  give  at  once  an  ordinary  dose  of 
physic,  and  as  soon  as  possible  get  the  shoes  on,  and  compel  the 
animal  to  walk  on  soft  ground,  if  obtainable ;  if  not,  on  the 
road  or  round  the  box  for  a  short  time,  until  a  little  of  the 
soreness  passes  off ;  for  however  difficult  it  may  be  for  him  to 
move  at  first,  it  always  lessens  from  exercise.  In  severe  cases  h 
is  often  necessary  for  a  person  to  walk  behind  the  animal  for  a 
short  time  to  compel  him  to  move  on.  Eegulate  the  amount . 
of  exercise  according  to  circumstances  ;  in  a  general  way,  give 
from  half-an-hour  to  one  and  a  half  hours  three  times  per  day, 
allowincj  the  horse  to  have  a  loose  box  when  not  at  exercise. 
Eepeat  the  physic  about  the  fourth  day  (depending  in  a  mea- 
sure on  the  effects  of  the  previous  dose,  although  I  never  saw 
any  ill  effects  from  the  repeated  physicking  in  such  cases),  until 
the  lameness  is  removed,  and  tlie  horse  fit  to  work,  which  he 
may  do  in  the  same  shoes,  or  lighter  ones  made  somewhat  after 
the  same  fashion,  as  it  will  be  better  for  the  horse  to  do  mode- 
rate work  than  to  remain  idle.  In  cases  arising  from  meta- 
stasis, or  excessively  long  journeys,  where  there  is  exhaustion, 
it  is  necessary  to  be  very  careful  with  regard  to  physicking. 
In  country  places,  when  there  is  a  difficulty  in  getting  the 
special  shoes  made  quickly,  the  horse  may  be  exercised  in  a 
field  in  his  ordinary  shoes,  or  without  any,  until  the  special 
shoes  be  made  and  put  on.  It  is  very  essential  that  no  time 
be  lost  before  the  treatment  is  commenced,  for  when  the  con- 
gestive stage  has  passed,  and  active  inflammation  is  going  on, 
it  is  necessary  to  be  very  cautious  wdth  regard  to  exercise.     If, 


368  DISEASES  OF  THE  FEET. 

from  neglect  or  improper  treatment,  separation  at  the  coronet 
has  commenced,  or  the  pedal  bone  is  so  far  displaced  that  there 
is  danger  of  its  toe  protruding  through  the  sole,  or  if  it  is  already 
through,  keep  the  special  shoes  on,  dress  daily  with  hot  tar 
until  the  opening  in  the  sole  has  been  filled  up,  and  a  particle 
of  horny  matter  thrown  out  and  become  dry ;  after  which,  as 
soon  as  the  horse  can  walk,  get  him  into  the  wettest  pasture 
that  can  be  found,  and  if  he  is  not  excessively  lame,  take  his 
shoes  off,  rasp  the  heel  low,  and  shorten  the  toes,  so  as  to  bring 
the  sole  in  contact  with  the  ground.  This  operation  is  to  be 
repeated  every  three  or  four  weeks,  which  will  in  time  ensure 
sound  and  perfect  feet  as  before  the  attack  occurred,  notwith- 
standing that  all  four  of  the  pedal  bones  may  have  protruded 
through  the  soles ;  but  it  may  require  from  six  to  twelve 
months  before  a  new  wall  has  grown  down  perfect  and  the 
sensitive  lamina  recovered  its  normal  exudative  powers.  If 
the  feet  are  not  properly  and  regularly  attended  to,  they  will 
not  recover  their  natural  shape,  but  will  be  deformed,  especi- 
ally at  the  toes.  A  wet  pasture  is  essential,  as  the  horn  will 
gTOW  as  much  in  one  month  as  it  would  in  three  months  on  dry 
ground. 

"  Should  the  horse  be  suitable  for  farm  work,  he  may  be  used 
on  soft  land  for  months  before  he  is  fit  for  fast  road  work. 

"Subacute  laminitis  is,  in  the  majority  of  cases,  a  transi- 
tional stage  from  the  acute  to  the  chronic.  Very  few  cases 
remain  subacute  which  begin  as  acute  ;  yet  you  may  have  cases 
the  symptoms  of  which  may  be  moderate  in  intensity,  and  to 
be  considered  as  subacute  from  the  beginning. 

"The  treatment  of  subacute  and  chronic  laminitis  must  be 
a  modification  of  that  of  the  acute  disease." 

Like  Mr.  Broad  I  have  treated  a  great  number  of  horses 
suffering  from  laminitis,  and  very  successfully  without  exercise. 
If  a  horse  will  not  lie  down  of  his  own  accord,  he  ought  to  be 
cast,  when  very  often  the  relief  which  is  thus  obtained  by  him 
will  cause  him  to  remain  recumbent  for  many  hours  or  even 
days.  If  he  lie  down  persistently  he  ought  to  be  turned  over 
every  four  hours  or  so,  bedded  on  clean  dry  material,  and  pre- 
cautions taken  against  bruising  or  other  injuries.  If  he  be 
unable  to  urinate  freely,  the  catheter  must  be  inserted  and  the 
mine  drawn  off  at  least  four  times  during  the  twenty-four  hours. 


LAMINITIS.  309 

or  more  frequently  if  the  animal  express  uneasiness  and  a  desire 
to  micturate. 

Every  case  of  laminitis  should,  if  possible,  be  stabled  in  a 
large,  airy,  well-ventilated  loose  box,  the  floor  covered  with 
plenty  of  short  straw,  chaff,  or  other  material  that  will  not 
entangle  the  animal's  feet  and  legs. 

I  do  not  recommend  slinging  except  in  cases  that  will  or  can 
not  lie  down. 

If  lameness  threatens  to  remain,  mild  blisters  may  be  applied 
to  the  coronets  with  advanta^^e. 


1!  B 


CHAPTER  XX. 

DISEASES  OF  THE  FEET — continued, 

DISEASES  OF  THE  HORN-SECRETING  STRUCTURES — VILLITIS — CARBUNCLE 

OF     CORONARY     BAND — FALSE-QUARTER SAND-CRACK HORN 

TUMOURS — SEEDY-TOE — CORNS — THRUSH — CANKER. 

DISEASES  OF  THE  HORN-SECRETING  STRUCTURES  OF  THE  FEET. 

Laminitis,  if  confined  to  the  soft  structures  of  the  foot,  might 
with  propriety  be  classified  under  this  head ;  but  as  it  involves 
the  pedal  bones  as  well  as  the  laminse,  I  have  arranged  it  under 
the  first  divisioiL 


INFLAMMATION  OF  THE  CORONARY  SUBSTANCE — VILLITIS 
(haycock) — CORONITIS. 

Seen  in  heavy  cart-horses,  and  occasionally  in  better-bred 
ones.  Symptoms — harshness  and  brittleness  of  the  crust ;  loss 
of  toughness  and  pliability;  increased  heat  round  the  coronet 
and  upper  part  of  the  crust;  often  a  fulness  of  the  coronary 
band,  and  tenderness  on  pressure ;  a  shuffling  gait,  if  both  fore 
feet  are  affected ;  the  heels  are  first  put  to  the  ground  ;  but  not 
to  the  same  extent  as  in  laminitis ;  a  desquamation,  or  a  ten- 
dency thereto,  of  the  coronary  substance,  shown  by  a  line  of 
separation  between  it  and  the  crust;  diminished  secretion  of 
horn ;  and  a  peculiar  striated  or  striped  appearance  of  the  crust, 
well  described  by  Haycock  in  his  essay  on  "Villitis."  The 
peculiarity  of  gait  is  due  to  the  animal  trying  to  glide  his  feet 
along  the  ground.  The  duration  of  this  form  of  lameness  is 
variable,  but  it  generally  lasts  a  few  weeks.  It  is  distinguish- 
able from  laminitis  by  the  peculiar  appearance  of  the  crust,  and 
the  bulging  round  the  coronet. 

Treatment. — Rest ;  removal  of  ordinary  shoes ;  poultices  to 
the  feet  for  a  few  days,  and  the  application  of  Mr.  Broad's 


VILLITIS.  371 

slioes,  either  barred  or  open ;  cold  applications  to  the  coronets  ; 
and  when  the  heat  and  tenderness  have  subsided,  mild  blisters. 
To  reduce  any  constitutional  disturbance,  and  the  local  inflam- 
mation, purgatives  may  be  given  occasionally.  If  the  animal 
does  not  become  sound  with  this  treatment,  he  nmst  be  allowed 
a  run  at  grass. 


CARBUNCLE  OF  THE  CORONARY  BAND,l 

Called  Furuncidus  by  Mr  M'Eachran,  Montreal,  attributed  to 
frost-Htes  by  others,  consists  of  an  oval  or  irregular  portion  ot 
the  coronary  substance  becoming  infiltrated  with  unhealthy 
lymph,  forming  at  first  a  hard  swelling  of  variable  size,  very 
painful ;  sometimes  extending  all  round  the  coronet ;  or  appear- 
ing at  other  times  as  several  patches  or  spots  of  inflammation ; 
accompanied  by  great  pain,  lameness,  and  a  high  degree  of 
febrile  disturbance.  After  a  few  days  suppuration  sets  in, 
most  commonly  at  several  points,  with  ulceration  of  the  soft- 
ened portions,  forming  so  many  apertures  or  sinuses,  which 
discharge  a  thin,  unhealthy,  ichorous  pus.  The  apertures  en- 
large by  ulceration  or  even  sloughing  of  their  borders,  and  by 
confluence  constitute  a  most  formidable  looking  and  unhealthy 
wound.  In  aggravated  and  malignant  cases,  other  inflammatory 
points  appear  upon  the  pastern  and  fetlock,  extending  in  some 
instances  as  high  as  the  knee  or  hock,  causing  sloughing  of 
great  patches  of  skin  and  subcutaneous  tissues,  exposing  the 
tendons,  nerves,  blood-vessels,  and  even  the  cavities  of  the 
joints,  and  producing  so  high  a  state  of  fever  and  suffering  as  to 
destroy  the  animal's  life. 

Mr.  Eobinson  of  Greenock  describes  some  of  his  cases  to  have 
presented  the  following  symptoms  : — Lameness  and  febrile  dis- 
turbance. On  examining  the  limb,  the  integuments,  in  some 
part  between  the  knee  or  hock  and  the  foot,  will  be  found 
gangrenous,  with  a  dew  upon  the  surface ;  sinking  on  pressure ; 
having,  in  fact,  a  doughy  feel.  In  a  day  or  two  a  line  of  demar- 
cation makes  it  appearance,  and  separation  of  the  gangrenous 
part  takes  place.  Wlien  not  involving  the  coronary  substance, 
Mr.   Eobinson   says   that   the    result   was    always    favourable. 

^  Carbuncle  of  the  coronary  baud  is  a  disease  similar  to  malignant  onychia  of 
the  human  being. 


372  DISEASES  OF  THE  FEET. 

Treatment. — Poulticing  at  first,  to  encourage  the  separation ; 
afterwards  digestives,  to  stimulate  the  granulations ;  and  finally 
mild  astringent  dressings.  Mr.  Eobinson's  cases  have  all  oc- 
curred in  the  winter,  and  he  attributes  them  to  cold  and  wet. 
I  have  seen  many  cases  at  times  when  they  could  not  be  attri- 
buted to  wet  or  cold,  and  which  seemed  to  be  unmistakeably  due 
to  a  blood-poison ;  they  were  also  more  malignant  and  unman- 
ageable than  those  witnessed  by  Mr.  Eobinson. 

I  believe  this  disease  is  hitherto  undescribed  by  any  English 
author ;  but  I  know  several  veterinarians  who  have  met  with 
cases  of  it  as  well  as  myself. 

I  am  inclined  to  think  that  it  is  due  to  a  blood-poison 
similar  to  that  of  glanders  and  farcy,  as  it  is  oftenest  seen  in 
unhealthy  situations,  ill- ventilated  stables,  and  in  horses  with 
bad  or  gross  constitutions.  I  was  inclined,  when  I  first  saw 
it,  to  attribute  it  to  some  injury  to  the  parts,  and  to  believe 
that  the  unhealthy  action  was  the  consequence  of  such  injury, 
or  to  the  introduction  of  some  deleterious  material  into  the 
wound ;  but  further  experience  has  convinced  me  that  it  often 
originates  from  constitutional  causes,  and  that  it  is  an  inflam- 
mation of  the  coronary  substances,  due  to  the  presence  of  some 
morbid  material  in  the  blood.  If  the  attack  be  slight,  the 
inflamed  point  limited,  circumscribed,  and  surrounded  by 
healthy  tissue,  recovery  may  be  expected ;  but  if  there  are 
several  points,  which  by  ulceration  tend  to  coalesce,  as  well  as 
extensive  destruction  of  tissue,  an  unfavourable  termination 
may  be  looked  for.  Even  if  recovery  from  the  more  immediately 
dangerous  symptoms  is  obtained,  such  will  be  the  destruction 
of  the  horn-secreting  structures  that  the  animal  will  be  worth- 
less for  the  future  ;  therefore  the  treatment  must  be  directed 
to  the  prevention  of  the  spreading  of  the  disease  from  its 
original  point;  and  the  best  local  remedy  for  this  purpose  is 
the  nitrate  of  silver,  freely  applied  in  its  undiluted  state. 
After  the  free  application  of  the  caustic,  the  animal  ought  to  be 
made  to  stand  with  the  lame  foot  in  cold  water,  for  an  hour 
at  a  time,  repeatedly  during  the  day;  poultices  are  injurious, 
as  they  encourage  the  tendency  to  sloughing  and  ulceration. 
When  the  foot  is  removed  from  the  cold  water,  the  parts  are  to 
be  dressed  with  a  solution  of  the  tincture  of  terchloride  of  iron. 
In  all  cases  of  this  description,  removal  of  the  shoe  and  ex- 


CARBUNCLE  OF  CORONARY  BAND.  37^ 

amination  of  the  foot  are  imperative.  The  general  febrile 
disturbances  are  to  be  combated  by — 1st.  A  brisk  cathartic ; 
2d.  Sedatives  or  anodynes,  as  the  case  may  require — anodynes 
if  the  pain  be  acute,  sedatives  if  the  febrile  symptoms  pre- 
dominate. The  caustic  is  to  be  applied  every  second  day,  imtil 
it  is  seen  that  the  ulcerations  are  becoming  healthy  in  appear- 
ance. I  have  tried  the  carbolic  acid  dressings,  but  they  are 
not  to  be  compared  with  the  nitrate  of  silver,  cold  water,  and 
astringents.  It  must  be  remembered  that  the  caustic  is  not 
to  be  applied  for  the  purpose  of  destroying  healthy  tissue,  but 
to  induce  healthy  action  in  what  is  already  diseased ;  it  must 
therefore  be  used  with  cautious  freedom. 

The  appetite  is  to  be  stimulated  by  tenipting  food ;  care  must 
be  taken  not  to  let  the  strength  be  reduced  by  the  want  of 
proper  nourishment ;  and  as  soon  as  the  most  acute  febrile 
symptoms  have  passed  off,  tonics,  especially  the  salts  of  iron, 
are  to  be  given.  The  stable  must  be  well  ventilated,  clean,  and 
well  drained ;  in  fact,  the  surroundings  of  the  animal  are  to  be 
of  the  best  kind. 

The  result  of  a  modified  form  of  this  disease  may  be  a  false- 
quarter. 

FALSE-QUARTER. 

This  consists  of  one  or  more  clefts  or  fissures  in  any  part  of  the 
crust  or  wall  of  the  foot,  due  to  the  destruction  of  the  secretory 
coronary  band. 

The  horny  wall  or  crust  of  the  foot  being  secreted  by  the 
coronary  substance,  it  naturally  follows  that  when  a  part  of  it 
is  destroyed,  the  part  of  the  wall  below  the  destroyed  portion 
is  no  longer  supplied  with  horn  from  above  ;  and  this  deficiency 
causes  a  chasm  or  fissure  in  the  wall.  It  differs  from  "  sand- 
crack  "  very  materially ;  is  much  wider  at  its  base,  and  contains 
a  modified  condition  of  horn;  that  is,  the  horny  laminae — 
secreted  by  the  sensitive  ones — denuded  of  their  outer  covering. 
The  coronary  band  also  shows  a  loss  of  substance  corresponding 
to  that  in  the  crust. 

A  horse  having  a  "  false-quarter,"  although  he  may  not  at  the 
time  show  any  signs  of  lameness,  is  to  be  considered  unsound, 
since  he  is  liable  to  become  lame  at  any  time,  from  injury  to 
the  thin  horny  covering  of  this  part  of  the  foot,  which  is  also 


374  DISEASES  OF  THE  FEET. 

more  or  less  tender,  and  requires  careful  shoeing,  in  order  tliat 
no  undue  weight  be  thrown  upon  the  weakened  portion. 

Causes. — Anything  that  destroys  the  integrity  of  the  coronary 
substance,  such  as  treads,  quittors,  &c. 

The  treatment,  if  there  be  a  wound,  must  be  directed  to  the 
diseased  coronet ;  removing  all  ragged  edges,  making  the  wound 
as  level  as  possible,  and  moulding  the  parts  into  their  natural 
condition,  as  nearly  as  can  be  done,  by  firm  pressure ;  bringing 
the  edges  of  the  wound  together,  and  inducing  it  to  heal  by 
secondary  adhesion.  If  the  case  be  an  old  one,  the  gap  in  the 
coronet  healed  up,  and  filled  with  fibrous  tissue,  but  little  can 
be  done,  except  filling  the  fissure  with  gutta-percha  from  time 
to  time  as  occasion  msuy  require,  and  applying  a  bar  shoe,  so  as 
to  throw  the  bearing  from  the  weak  part.  Blisters  to  the 
coronet  are  sometimes  useful. 

Tricks  are  played  upon  feet  of  this  kind ;  false-quarters,  sand- 
cracks,  and  seedy-toes  are  filled  with  gutta-percha,  moulded  to 
the  part  whilst  warm,  nicely  filed  or  rasped  when  cold,  and  the 
whole  surface  of  the  foot  blackened  with  lamp-black  and  oil,  or 
covered  with  tar. 

Caution. — Never  examine  a  horse  as  to  soundness  if  the  feet 
are  dirty,  without  having  them  washed. 


SAND-CRACK. 

A  sand-crack  consists  of  a  fissure  of  greater  or  lesser  extent 
in  any  part  of  the  foot,  commencing  at  the  coronet,  and  generally 
found  in  the  inner  quarters  of  the  fore  and  the  toes  of  the 
hind  feet,  very  rarely  in  the  outer  quarters. 

Professor  Dick  taught  that  "  a  sand-crack  may  happen  in 
an  instant,  from  a  false  step ;  and  hence  a  horse,  though  he  may 
spring  a  sand-crack  within  an  hour  after  purchase,  cannot  be 
returned  on  that  account  to  the  seller."  This  opinion  is  held 
by  many  other  writers  and  teachers ;  but  it  is  incorrect,  except 
in  very  rare  instances.  A  sand-crack  proceeds  by  slow  degrees. 
Prior  to  its  appearance,  the  horn  is  imperfectly  secreted ;  it  is 
dry  and  brittle.  Horn  is  built  up  of  tubes  matted  together. 
These  tubes  are  similar  to  hair,  and  are  secreted  by  the  same 
kind  of  cells.  And  "  the  same  cell  which  forms  the  scaly 
epithelium,  epidermis,  and  hair  is  utilized  in  building  up  the 


SAND-CRACK.  375 

horny  structures.  The  special  history  of  the  horny  appendages 
of  animals  consists  therefore  in  the  description  of  the  form  and 
disposition  of  the  surfaces  from  which  they  spring.  Whereas 
hairs  have  roots  embedded  in  follicles,  the  horn  tubes  spring 
from  papillae,  which  stud  a  surface  extended  over  bony  or  fibro- 
elastic  prominences." — (Gamgee.) 

Horn  is  often  spoken  of  as  "  built  of  hairs  firmly  matted 
together "  (Barlow).  The  horn  tubes  are  united  together  by 
an  inter-tubular  substance  composed  of  cells,  and  produced  from 
the  surface  between  the  papillae.  The  wall,  consisting  of  horn 
tubes  and  agglutinating  inter-tubular  substance,  is  secreted  by 
the  coronary  substance,  and  is  naturally  tough,  but  breaks  into 
fibres  if  it  grows  beyond  its  natural  length.  This  is  due  to  the 
crumbling  of  the  inter-tubular  substance. 

In  order  that  normal  horn  be  secreted,  it  is  essential  that 
the  papillae  and  intermediate  spaces  in  the  coronary  band,  as 
well  as  the  sensitive  laminae,  be  in  a  healthy  condition ;  for  it 
is  found  that  the  very  tough  and  natural  state  of  the  wall  is 
maintained  and  preserved  by  the  continual  addition  to  it  of 
horny  agglutinating  cells,  secreted  by  the  sensitive  laminae  as 
it  (the  wall)  descends  over  the  foot. 

Having  seen,  then,  that  the  horn  is  secreted  by  the  papiUae 
and  the  inter-papillary  substance,  the  reader  can  understand 
that  the  brittle  condition  of  the  crust  leading  to  sand-crack 
depends  upon  a  perverted  condition  of  the  secreting  structures. 

Some  horses  are  very  liable  to  these  cracks;  and  when  a  cure  has 
been  apparently  effected,  they  (the  cracks)  are  very  apt  to  return. 
Such  may  be  said  to  be  naturally  predisposed ;  but  the  cause 
must  be  looked  for  in  the  deteriorating  effects  of  bad  shoeing, 
especially  in  that  method  which  ignores  the  weight-bearing 
properties  of  the  sole.  When  the  sole  is  weakened  by  the 
drawing-knife,  and  shoes  applied  to  the  feet,  more  especially  the 
seated  shoes  which  are  put  on  the  fore  feet,  the  weight-bearing 
surface  is  limited  to  the  thickness  of  the  wall ;  and  an  amount 
of  weight  is  thus  thrown  on  the  crust  calculated  to  overstrain 
it,  and  to  induce  diseased  action  in  the  structures  to  which  it  is 
attached,  and  by  which  it  is  secreted.  Of  itself  horn  is  in- 
capable of  diseased  action,  being  a  secreted  and  not  a  formative 
material. 

A  sand-crack  commences  at  the  thin  upper  margin  of  the 


376  DISEASES  OF  THE  FEET. 

wall,  and  is  usually  small  and  insignificant  at  first ;  but  it 
gradually  extends  downwards  and  inwards,  and  when  it  has 
penetrated  through  the  horny  structures,  lameness  becomes 
apparent ;  inflammation  is  set  up,  both  in  the  laminge  and  with- 
in the  skin  above  the  fissure ;  the  part  is  very  painful,  and  the 
lips  of  the  wound,  at  its  upper  part,  gape  as  the  tissues  swell. 

In  some  rare  instances,  however,  lameness  may  be  present 
before  the  appearance  of  the  fissure.  When  such  is  the  case,  we 
may  reasonably  conclude  that  the  fissure  commences  on  the 
inner  part  of  the  wall,  being  the  converse  to  the  general  rule. 

When  the  animal  is  made  to  move,  the  crack  is  seen  to  close 
every  time  the  foot  is  put  to  the  ground,  and  to  open  again 
when  the  weight  is  removed  from  it;  during  this  closure  the 
borders  of  the  crack  grasp  some  of  the  sensitive  and  swollen 
tissues,  causing  most  excruciating  pain  and  sometimes  hsemorr- 
hase.  Sand  and  dirt  insinuate  themselves  into  the  wound,  act 
as  irritants,  give  rise  to  the  suppurative  action,  and  in  some 
instances  to  a  high  degree  of  irritative  fever.  It  is  very  painful 
to  witness  a  horse,  especially  a  heavy  cart-horse,  attempting  to 
walk  with  sand-crack  at  the  toe.  He  keeps  the  foot  elevated 
from  the  ground  as  long  as  possible ;  puts  down  the  heel  first 
very  carefully ;  and  when  the  toe  is  forced  to  touch  the  ground, 
he  immediately  lifts  the  foot  with  a  sudden  catch,  the  pain 
being  often  so  poignant  as  to  cause  him  to  groan. 

A  sand-crack  may  occur  through  the  bars,  but  it  is  very  rare. 

Treatment. — If  inflamed,  remove  all  sources  of  irritation,  and 
pare  the  edges  of  the  crack  if  they  press  upon  the  tissues ;  in 
fact,  "  bottom  the  crack^'  and  allow  the  escape  of  pus,  dirt,  &c. ; 
remove  the  shoe,  and  give  purgatives ;  order  fomentations  and 
rest.  A  fungous  growth  is  generally  seen  filling  the  fissure  ;  this 
is  the  result  of  the  inflammation,  depends  upon  it,  and  disap- 
pears upon  its  subsidence.  It  must  not  be  destroyed  by  caustic, 
for  the  application  will  add  to  the  irritation.  When  the  inflam- 
mation and  pain  have  subsided,  place  a  bar  shoe  (thin  heeled, 
with  side  clasps,  if  the  crack  be  in  the  toe)  on  the  foot,  allow  sole 
as  well  as  frog  pressure,  but  remove  the  pressure  from  that  part  of 
the  foot  immediately  below  the  crack ;  pare  away  the  upper  part 
of  the  crack  from  its  coronary  attachment,  and  let  no  direct 
communication  remain  between  the  fissured  horn  and  the  sub- 
stance from  which  new  horn  is  to  grow,  or  the  crack  will  be 


SAND-CRACK.  377 

perpetuated.  A  sand-crack  never  unites,  and  a  new  crust  must 
be  cultivated. 

There  are  two  operations  applicable  to  sand-crack  after  the 
inflammation  has  subsided,  namely,  the  French  plan  of  "  strip- 
ping," and  the  English  method  of  "  clasping."  The  first  should 
be  performed  only  in  very  aggravated  and  long-standing  cases. 
It  consists  in  making  a  groove  on  either  side  of  the  crack ;  the 
two  grooves  originating  in  a  point  about  the  middle  of  it, 
extending  upwards  to  the  coronet,  and  gradually  diverging  from 
each  other,  so  as  to  include,  at  the  coronet,  nearly  an  inch  of 
wall  on  either  side  of  the  fissure  in  the  form  of  the  letter  V- 
The  horn  is  to  be  cut  completely  through,  and  then  the  whole 
of  it  included  in  the  grooves  is  to  be  stripped  off  from  the  point 
to  the  coronet.  If  any  remains  of  the  sand-crack  be  seen  in 
the  sensitive  laminae,  they  are  to  be  cut  off  with  a  sharp  knife. 
Cold  applications,  bandages,  and  mild  astringents,  with  rest,  will 
constitute  all  the  after  treatment  necessary  ;  time  being  allowed 
for  the  growth  of  new  horn  before  the  animal  is  put  to  work. 

The  second  method — that  of  "  clasping " — is  of  two  kinds,  is 
much  milder,  and  answers  the  purpose  in  the  majority  of  cases. 
First  performed  as  follows  : — The  horn  immediately  attached  to 
the  coronet  above  the  crack  is  to  be  pared  away,  so  as  to  com- 
pletely disconnect  the  diseased  horn  from  the  coronary  sub- 
stance ;  then  a  clasp  is  to  be  applied,  w^hich  may  now  be  obtained, 
with  the  necessary  instruments,  from  any  surgical  instrument 
maker.  The  second,  and  the  better  when  the  horn  is  sufficiently 
thick,  as  when  the  crack  is  in  the  toe,  is  to  cut  a  notch  with  the 
drawing-knife  about  half-an-inch  from  each  side  of  the  crack,  as 
near  the  coronet  as  possible,  and  about  a  quarter  of  an  inch 
deep,  and  sufficiently  large  to. allow  the  imbedding  of  tlie 
head  of  a  small  horse-nail.  If  the  crack  be  an  old  one  and  Ion", 
other  notches  are  to  be  cut  an  inch  lower  down,  and  ordinary 
horse-nails,  pointed  with  a  broad  point  on  the  reverse  side,  are 
carefully  driven  into  the  horn  through  those  notches,  embracing 
both  sides  of  the  fissure,  long  clenches  being  left,  and  the  crack 
drawn  closely  together  with  the  pincers,  the  clenches  fastened 
down,  and  the  whole  rasped  smooth.  The  rationale  of  these 
methods  is  to  prevent  all  motion  in  the  crack  during  the 
movements  of  the  animal.  In  this  way  a  horse  may  be  em- 
ployed for  his  usual  work  during  the  growth  of  the  new  horn  \ 


378 


DISEASES  OF  THE  FEET. 


whereas,  if  no  clasp  or  nails  be  applied,  lameness  manifests 
itself,  from  the  pinching  of  the  sensitive  laminae  when  the  edges 
of  the  crack  approximate  each  other  at  the  time  the  foot  is  on 
the  ground,  as  already  explained.  It  is  always  necessary  to  see 
that  no  dirt  insinuates  itself  into  the  foot  through  the  fissure, 
and  to  keep  it  filled  with  some  firmly  adhesive  material,  such  as 
gutta-percha.  If  the  growth  of  horn  seem  inactive,  a  slight 
blister  to  the  coronet  will  prove  useful,  by  promoting  a  more 
rapid  secretion.  At  all  times,  and  for  sand-cracks  in  any  part  of 
tlie  foot,  a  bar  shoe,  if  the  frog  is  not  diseased  and  unfit  to  bear 
pressure,  is  useful.  In  this,  as  in  all  other  diseases  of  the  feet, 
the  sole  is  to  remain  unpared,  and  allowed  to  bear  its  due  share 
of  the  animal's  weight.  When  the  crack  is  at  the  quarter  a 
three-quartered  bar  shoe,  to  remove  weight  from  it,  is  to  be 
recommended. 


KERATOMA. 

The  two  following  woodcuts,  fac-similes  of  specimens  in  my 
possession,  will  illustrate  tliis  condition  of  the  foot : — 


Fig.  73. 


Fig.  74. 


Fig.  73. — Homy  foot,  showing  at  a  horn  tnmour. 

Fig.  74. — Pedal  bone  of  same  foot,  showing  a  cavity  at  its  toe  corresponding  to 
the  horn  tumour  in  Fig.  73. 


KEKATOMA.  379 

The  horn  tumour  seen  in  Fig.  73  is  caused  by  pressure  of  the 
toe-clip  of  the  shoe,  this  having  been  hammered  too  tightly  by 
the  smith,  or  becoming  so  by  the  animal  striking  the  toe  against 
the  ground.  These  tumours  and  their  corresponding  gaps  in  the 
pedal  bone  are  generally  found  in  the  toes  of  the  hind  feet ;  but 
it  is  by  no  means  an  uncommon  thing  to  find  them  in  the  fore 
feet,  at  the  sides  where  the  clips  of  the  shoe  are  situated.  I 
have  a  case  now  under  treatment  with  two  in  each  fore  foot. 
Generally,  a  kind  of  fissure  is  seen  in  the  outer  shell  of  the  wall, 
or  a  concavity  or  depression  without  an  actual  fissure.  There 
is  sometimes  lameness ;  occasionally  the  animal  goes  sound,  the 
absorption  of  the  bone  accommodating  the  horn  tumour.  A 
horse  whose  feet  are  in  this  state  is  unsound,  as  the  growth  of 
the  tumour  is  apt  to  cause  lameness.  Now  and  then  instances 
may  be  seen  where  there  is  no  apparent  cause,  no  pressure  of  the 
clip,  the  disease  being  apart  from  the  portion  of  hoof  upon  which 
a  clip  is  usually  situated.  These  tumours  are  analogous  to  corns 
in  the  human  feet,  and  consist  of  an  increased  secretion  of  horn, 
generally  caused  by  pressure. 

If  they  cause  lameness,  a  method  of  treatment  is  recom- 
mended, namely,  the  removal  of  the  whole  of  the  crust  im- 
mediately over  the  diseased  part,  by  cutting  through  it  on  either 
side  from  top  to  bottom,  detaching  it  from  the  sole,  and  tearing 
it  off,  leaving  the  sensitive  parts  exposed.  This  operation  is 
called  "  stripping  the  wall ;"  it  is  a  very  cruel  one,  and  should 
never  be  performed  except  where  the  disease  has  resisted  other 
treatment,  as  it  is  sometimes  followed  by  untoward  and  irre- 
moveable  results,  which  seem  to  have  escaped  the  notice  of  those 
who  advocate  its  performance,  not  only  for  horn  tumours,  but 
for  seedy-toe  and  sand-crack.-  These  results  are — (1.)  The 
formation  of  successive  abscesses  and  fistulse  in  the  coronary 
substance,  before  and  during  the  growth  of  the  new  horn :  (2.) 
Destruction  of  the  sensitive  laminse,  non-secretion  of  the  horny 
duplicates,  and  the  consequent  attaclmient  of  the  horny  wall  to 
the  OS  pedis  through  the  medium  of  a  form  of  fibrous  material, 
easily  excited  to  inflammation  and  suppuration :  (3.)  Formation 
of  abscesses  at  the  coronet  after  the  growth  of  the  new  wall, 
arising  from  the  sensitive  laminae,  bruised  and  lacerated  by  the 
force  of  the  operation,  degenerating  in  some  parts  into  circular 
fungoid  masses,  which  by  growth  separate  the  wall  from  its 


380        '  DISEASES  OF  THE  FEET. 

attachment,  and  occasion  much  lameness.  It  is,  therefore,  better 
to  modify  any  lameness  which  they  may  occasion  by  properly 
adjusted  shoes.  Should  these  prove  insufficient,  the  diseased 
portion  may  be  isolated  by  grooving,  as  in  the  process  of  strip- 
ping, but  the  horn  left  unstripped. 


SEEDY-TOE. 

This  term  is  applied  to  a  perverted  secretion  of  horn  at  the 
lower  margin  of  the  os  pedis,  by  which  the  crust  becomes  de- 
tached from  the  horny  laminae. 

It  is  often  a  result  of  laminitis,  or  of  the  pressure  of  the  clip 
of  the  shoe.  It  consists  in  the  formation,  by  the  surfaces  of  the 
sensitive  laminse,  of  a  cheesy  or  mealy  imperfect  horn,  which  is 
incapable  of  maintaining  the  union  between  the  outer  wall  and 
laminae.  Being  more  rapidly  secreted  than  healthy  horn,  it 
causes  a  separation  of  the  crust  from  the  laminae,  and  of  the 
sole  from  the  lower  margin  of  the  os  pedis.  Eapidly  drying,  it 
shrinks  in  bulk,  causing  a  vacant  space  between  them,  which 
emits  a  hollow  sound  when  percussion  is  applied  to  the  wall. 
"When  very  extensive,  there  is  usually  a  bulging  of  the  wall  at 
the  part  affected. 

Although  called  seedy-toe,  io  ia  not  confined  to  that  part  of 
the  foot,  being  often  seen  in  other  parts  of  it,  especially  the 
quarters.  When  not  due  to  laminitis,  or  to  the  pressure  of  the 
clips,  it  originates  in  some  inherent  cause,  such  as  weak  feet,  or 
in  the  weight-bearing  surface  of  the  foot  being  limited  to  the 
wall  by  bad  shoeing. 

Lameness  is  not  invariably  present ;  but  it  must  always  be 
considered  an  unsoundness,  as  it  is  easily  aggravated,  has  a  ten- 
dency to  spread,  and  great  lameness  is  produced  by  the  insinua- 
tion of  dirt  and  gravel. 

If  treatment  is  to  be  adopted,  it  should  consist  in  the  removal 
of  all  the  diseased  parts,  and  in  the  promotion  of  the  gTowth 
of  healthy  horn  by  blisters  and  moisture.  Bar  shoes,  sole 
pressure,  and  removal  of  shoe-clips  are  the  instructions  for  the 
farrier. 

Some  people  think  that  white  feet  are  more  liable  to  suffer 
from  seedy-toe  than  dark-coloured  ones.  This  is  a  mistake, 
seedy-toe  being  as  often  foimd  in  dark  as  in  white  feet,  in  the 
fore  as  well  as  in  the  hind  feet. 


CORNS. 


381 


CORNS. 

A  corn  is  the  result  of  a  bruise,  involving  the  structures  of  the 
sensitive  sole,  appearing  as  an  ecchymosed  spot  in  the  triangular 
space  included  between  the  bars  and  the  wall  at  the  heel ;  oc- 
curring in  the  fore  feet,  and  almost  invariably  in  the  inside  heel ; 
and  caused  by  bad  shoeing.  Corns  are  not  horn  tumours,  as 
taught  by  Gamgee  and  others,  but  they  may  become  so,  if  the 
cause  be  long  applied. 

The  ordinary  seated  shoe  is  the  most  irrational  invention  that 
ever  emanated  from  a  man's  brain.  It  is  a  thing  that  bears 
upon  no  part  of  the  sole  except  upon  the  spot  that  is  incapable 
of  bearing  such  pressure.  It  is  dished  out — made  concave — all 
round  the  foot  except  at  the  heels  ;  and  the  result  is  corns.  A 
corn  consists  essentially  at  first  of  a  bruise  and  extravasation  of 
blood,  from  rupture  of  the  small  vessels,  which  insinuates  itself 


Fig.  75. 


into  the  horny  texture,  and  gives  it  the  characteristic  red  appear- 
ance ;  it  terminates  occasionally  in  suppuration,  partial  necrosis, 
horn  tumour,  or  in  the  formation  of  bony  spiculae  on  tlie  plantar 
surface  of  the  pedal  bone,  as  represented  in  the  sketch. 


382  DISEASES  OF  THE  FEET. 

A  corn  constitutes  an  unsoundness,  although  it  may  not  at  the 
time  cause  lameness. 

Treatment. — If  inflammation  be  present,  treat  accordingly; 
remove  shoes ;  poultice,  &c.  Give  exit  to  pus  if  the  corns  have 
festered ;  and  if  there  be  superficial  necrosis  of  the  pedal  bone, 
the  sequestrum  must  be  removed.  The  radical  cure,  however, 
is  to  be  effected  by  proper  shoeing,  and  the  method  already  laid 
down  is  certain,  speedy,  and  recommends  itself  to  all  impartial 
men.  Horses  that  are  high  steppers,  with  heel  action,  are  most 
susceptible  to  corns,  especially  if  weak  in  the  heels ;  but  corns 
are  seen  in  the  best  of  feet,  and  they  will  continue  to  be  seen 
while  horses  are  shod  with  the  seated  shoe.  One  other  cause 
of  corns  is  the  maceration  of  the  feet  by  vile  combinations  called 
"  stoppings,"  which  cannot  be  too  strongly  condemned. 

THRUSH. 

A  discharge  of  a  foetid  material  from  the  frog,  arising  from  a 
diseased  condition  of  the  secretory  surface  of  the  fibro-fatty  frog. 
The  cleft  is  the  part  commonly  first  affected,  and  when  neglected 
the  disease  spreads  over  the  whole  organ ;  the  horn  becoming 
detached  from  the  bulbs  of  the  heels  to  the  toe  of  the  frog. 
The  causes  are  extrinsic  and  intrinsic.  The  extrinsic  causes  are 
filth,  the  irritating  materials  generated  in  the  decomposition  of 
the  urine  and  faeces,  and  contained  in  stoppings  for  the  feet,  such 
as  cow-dung,  and  maceration  of  the  frog,  as  when  the  animal  is 
turned  out  to  a  wet  pasture  :  these  causes  operate  by  destroying 
the  integrity  of  the  horny  frog,  and  irritating  its  sensitive 
counterpart.  Thrushes  from  extrinsic  causes  are  more  com- 
monly found  in  the  hind  than  in  the  fore  feet,  because  the  latter 
are  not  in  the  dirt  while  the  animal  is  in  the  stable.  The  intrinsic 
causes  operate  chiefly  on  the  fore  feet, — although  thrushes  may 
be  seen  in  the  fore  feet  if  the  animal  be  at  grass,  in  a  wet  straw- 
yard,  or  in  a  dirty  loose  box.  In  the  winter  time  the  frog 
denuded  of  its  horn  becomes  occasionally  frost-bitten,  leading 
to  deep  sloughing,  which  may  even  extend  to  the  navicular  bursa, 
and  causing  great  lameness. 

Thrushes  are  easily  cured,  when  originating  from  external 
causes,  by  cleanliness,  and  calomel  locally  applied ;  and  if  it  be 
impossible  to  prevent  the  animal  from  standing  in  his  excreta, 


THRUSH.  383 

leather  soles  should  be  used ;  these  may  be  moveable,  and  used 
only  while  the  horse  is  in  the  stable. 

"When,  from  the  intrinsic  cause  already  referred  to,  or  from 
some  habit  of  body  (cachexia),  with  swelling  of  the  legs,  or 
grease,  the  cure  becomes  a  difficult  matter,  purgatives,  dress- 
ing with  calomel,  tonics  if  necessary,  regular  exercise,  and  great 
cleanliness,  will  be  necessary. 


CANKER 

Differs  from  thrush  in  the  nature  of  the  diseased  secretion,  in 
its  course  and  tractability.  It  usually  commences  in  the  frog, 
and  rapidly  extends  to  the  sole,  and  even  the  sensitive  laminae  ; 
but  it  is  not  a  rare  thing  to  see  it  commencing  in  any  other 
part  of  the  plantar  surface,  or  of  the  laminated  structure  of  the 
wall,  excited  by  a  wound,  prick,  or  other  injury.  It  much 
resembles  grease  of  the  leg,  both  in  its  nature  and  the  class  of 
animal  it  attacks  ;  and  very  frequently  both  conditions  are  co- 
existent. I  have  investigated  the  condition  of  the  parts  micro- 
scopically, but  have  failed  to  detect  any  malignant  characteristic.. 
The  papillse  are  enlarged  by  engorgement,  or  by  hypertrophy, 
but  show  no  trace  of  cancer  or  malignant  disease ;  nor  of  lym- 
phoid or  tubercular  deposition,  as  in  some  cases  of  foul  in  the 
feet  of  horned  cattle.  In  some  instances  such  bodies,  like  the 
sporulcs  of  a  vegetable  parasite,  are  to  be  seen  under  the  micro- 
scope ;  perhaps  further  research  will  demonstrate  that  canker  is 
due  to  the  presence  of  a  cryptogam. 

The  characteristic  symptoms  of  the  disease  are  strongly 
marked,  and  consist  of  an  abundant  foetid,  colourless  discharge 
from  the  frog,  which  is  large,  spongy,  and  covered  by  pallid, 
stringy  prominences  of  a  fungoid  nature,  intermixed  with  offen- 
sively smelling,  semi-dried,  cheesy  masses  of  matter,  composed 
of  imperfect  horn  cells.  It  seems  as  if  the  various  constituents 
of  the  horn  were  in  an  uncombined  state ;  the  sulphur,  which 
is  a  natural  constituent,  being  secreted  as  sulphuretted  hydro- 
gen, giving  the  characteristic  foetor  to  the  whole  secreted  mass ; 
the  horny  matter  imperfect,  and  floating  in  an  abundant 
liquid  material ;  the  secreting  villi  enlarged,  scantily  covered  by 
a  thin  pellicle  of  horn,  giving  them  superficially  a  while  appear- 
ance, whilst  underneath  they  are  turgid,  congested,  and  humid. 


384  DISEASES  OF  THE  FEET. 

Canker  may  be  confined  to  one  foot.  When  resulting  frorii 
an  injury  it  is  always  so  ;  but  when  originating  from  no  osten- 
sible cause,  two,  three,  or  even  all  the  feet,  may  be  contem- 
poraneously or  successively  affected.  The  sound  feet  of  a  horse 
predisposed  to  canker  very  often  have  an  abominable  smell,  as 
if  the  animal  suffered  from  a  sulplmrettecl  hydrogen  diathesis.  I 
have  coined  this  term,  not  being  able  to  find  another  to  express 
my  meaning. 

Canker  is  generally  confined  to  heavy  cart-horses.  Some 
writers  say  that  neglected  thrushes  are  apt  to  run  ou  to  canker, 
I  am,  however,  of  opinion  that  such  is  not  the  case,  unless  there 
be  a  strong  predisposition ;  and  when  this  is  present,  thrush,  or 
even  an  injury,  may  excite  its  development.  Canker  is  a 
constitutional  disease  located  in  the  feet,  and  is  due  to  a 
cachexia  or  habit  of  body,  grossness  of  constitution,  as  exhibited 
by  thick  round  legs,  large  feet,  and  the  lymphatic  temperament. 

The  treatment  of  canker  is  early  extirpation,  not  only  of  the 
diseased  surface,  but  of  the  whole  horny  solar  aspect  of  the  foot, 
and  is  performed  as  follows : — With  a  sharp  drawdng-knife  make 
a  groove  at  the  immediate  junction  of  the  sole  and  w^all  all  round 
the  foot,  commencing  at  the  heel,  extending  round  the  toe,  and 
to  the  other  heel.  Then  divide  the  circle  into  tw^o  halves,  by 
making  another  groove  from  the  cleft  of  the  frog  to  the  toe  of 
the  foot.  The  patient  must  now  be  cast  and  properly  secured. 
Then  with  a  sharp  scalpel  cut  cleanly  through  the  grooves  into 
the  sensitive  parts,  so  as  to  completely  separate  the  sole  from 
the  wall.  Wlien  this  is  done,  strip  off  one-half  of  the  sole  first, 
and  then  the  other  half,  removing  every  trace  of  the  horny 
covering  of  both  sole  and  frog.  It  must  be  done  thoroughly  and 
effectually.  Cut  away  all  fungous  grow^ths,  and  dress  the  whole 
of  the  exposed  surface  with  the  nitrate  of  silver.  Pack  up  with 
dry  tow,  bandage,  and  put  on  a  leather  boot.  Apply  moderate 
pressure  to  the  fetlock "  by  a  tourniquet,  to  prevent  excessive 
haemorrhage.  I  find  it  unnecessary  to  do  this  until  after  the 
operation  is  completed,  as  bleeding  does  not  begin  until  the 
animal  is  on  its  feet  again.  Two  days  after  the  operation,  the 
dressings  are  to  be  thoroughly  soaked  in  warm  water  for  an  hour, 
and  carefully  removed.  If  removed  dry,  they  are  apt  to  tear 
away  pieces  of  the  textures,  to  which  they  are  firmly  agglutinated 
by  the  dried  blood.     Great  care  must  be  exercised  in  doing  this, 


:■■  CANKER.  dS5^. 

as-  everytliing  torn  now  leaves  a  raw  surface  difficult  to  heal.    In 
some  instances  the  whole  of  the  exposed  surface  of  the  foot 
presents  a  beautifully  healthy  appearance,  and  become  gradually 
covered  with  natural  horn,  with  very  little  more  treatment  than 
cleanliness,  mild  astringents,  and  moderately  firm  pressure.    But 
the  more  aggravated  ones  will  continue  to  present  fungoid  ele- 
vations and  morbid  secretion,  requiring  repeated  dressings  with 
powerful   caustics   and   astringents.       Chromic   acid,   carefully 
applied  in  its  undiluted  state,  is  a  good  remedy,  combining  with 
the  watery  constituents  of  the  fungoid  growths,  and  stimulating 
the  production  of  healthy  horn.     It  must  be  sparingly  applied, 
as  its  affinity  for  water  is  so  great  as  to  cause  a  blaze  of  fire  by 
the  intensity  of  their  combination.    For  at  least  a  week  after  the 
operation,  the  horse  should  stand  without  shoes,  the  soles  being 
padded  with  tow,  bandaged,  and  booted ;  but  when  the  feet  are 
able  to  bear  the  shoes,  they  should  be  put  on,  since  it  is  much 
easier  to  dress  the  feet  when  they  are  on.     The  after  treatment 
wdll  depend  very  much  on  the  progress  of  the  disease ;  remedies 
seem  to  lose  their  eflect  after  two  or  three  applications,  and  re- 
quire to  be  changed.    When  the  chromic  acid  seems  inoperative,- 
a  mixture  of  sulphuric  acid  and  tar  might  be  tried,  or  the  acid 
carefully  put  on  in  its  undiluted  state.     Care,  however,  must  be 
taken  not  to  continue  caustic  and  escharotic  dressings  too  long, 
or  the  whole  sensitive  sole  will  be  destroyed,  necrosis  of  the 
l)one  produced,  with  great  sloughing,  and  perhaps  the  death  of 
the  horse.     Burnt  alum,  sulphate  of  copper,  terchloride  of  iron, 
chloride  of  zinc,  sulphate  of  iron,  tannic  acid,  and  other  astrin- 
gents, with  an  occasional  application  of  carbolic  acid,  might  be 
tried  in  their  turn.     Some  cases  improve  under  firm  pressure,  by 
means  of  pledgets  of  tow  and  splints ;  whilst  in  others,  pressure 
seems  to  stimulate  the  diseased  action  and  the  production  of 
fungus.      There  is  scarcely  a  rule   which  can  be  laid   down. 
Much  depends  on  the  skill  of  the  veterinary  attendant.     The 
stripping  must  not,  however,  be  forgotten,  and  it  may  be  neces- 
sary to  repeat  the  operation.     Many  horses  have  recovered  that 
have  required  it  to  be  done  three,  or  even  more  times.     When 
the  laminae  are  involved,  the  case  may  be  generally  looked  upon 
as  hopeless ;  but  if  treatment  is  determined  upon,  the  crust  must 
be  stripped,  so  as  to  expose  the  whole  of  the  diseased  surface. 
The  constitution,  being  the  source  and  origin  of  the  ailment, 

2c 


386  DISEASES  OF  THE  FEET. 

must  not  be  forgotten.  Purgatives,  diuretics,  tonics,  alteratives, 
such  as  arsenic  and  deobstruents,  are  to  be  employed  to  get  it 
into  a  good  state  of  health,  with  regular  exercise,  good  dry  food, 
great  cleanliness,  and  a  dry  situation.  In  all  cases  of  canker  the 
dressings  should  be  removed  daily ;  and  when  pressure  or  pro- 
tection by  an  artificial  sole  seems  hurtful,  the  foot  should  be  left 
uncovered,  dressed  over  with  tar,  and  repeatedly  cleansed  with 
cold  water  every  day.  If  in  a  fore  foot,  this  is  easily  done  ;  but 
a  hind  foot  requires  more  trouble  and  care.  When  a  thin  pellicle 
of  horn  has  formed,  gentle  pressure,  by  means  of  pledgets  of  tow 
dipped  in  tar,  will  prove  useful  in  all  cases.  Such  pressure  may 
be  constant  or  intermitting,  as  the  discretion  of  the  practitioner 
may  lead  him  to  prescribe. 


CHAPTER  XXL 

DISEASES  OP  THE  FEET — Continued, 

PUNCTURES  or  THE  FEET  BY  "  GATHERED  NAILS "  AND  BY  "  PRICKS "  IN 
SHOEING — IMPORTANCE    OF   THOROUGHLY   EXAMINING    WOUNDED 

FEET   AND   OF   GIVING   EXIT   TO    ALL    DISCHARGES WEAK    FEET 

LIABLE  TO  INJURIES — QUITTOR TREATMENT — FOUL  IN  THE  FOOT 

OF  HORNED  CATTLE — FOOT-ROT  IN  SHEEP. 

PRICKS  IN  SHOEING  AND  GATHERED  NAILS. 

A  "  GATHERED  NAIL  "  may  pierce  any  part  of  the  sole  or  frog,  but 
most  commonly  it  is  found  to  have  entered  one  of  the  commis* 
sures  of  the  frog,  and  about  midway  between  its  toe  and  the 
bulb  of  the  heel.  If  the  puncture  be  deep,  there  is  great  risk  of 
its  penetrating  the  navicular  bursa.  The  treatment  is  removal 
of  the  nail,  paring  of  the  part  to  allow  the  escape  of  pus, 
poultices,  and  rest. 

Punctures  or  pricks  in  shoeing  are  of  two  kinds,  namely,  those 
actually  penetrating  the  sensitive  structures,  and  those  where  the 
nails,  not  actually  penetrating  the  sensitive  parts,  are  driven  so 
near  as  to  cause  bulging  of  the  inner  layer  of  horn,  and  pressure 
upon  the  sensitive  interior,  leading  on  to  inflammation  and  great 
lameness,  with  or  without  suppuration. 

Many  cases  of  pricks  are  caused  by  what  are  termed  "  drawn 
nails;"  that  is  to  say,  the  smith,  finding  that  his  nail  has  gone  too 
near,  or  even  penetrated  the  sensitive  foot,  draws  it  out  and 
drives  it  in  again,  taking  a  more  superficial  hold  of  the  horn. 
These  cases  are  more  difficult  to  diagnose  than  when  the  nail 
causing  the  injury  is  not  removed ;  but  with  care  it  can  be  seen 
that,  although  the  nail-hole  is  pared  out,  a  stellate  discoloration 
remains  at  the  bottom  of  the  cavity  made  by  the  knife.  This 
must  be  followed  and  thoroughly  bottomed,  or  the  suppuration 


388  DISEASES  OF  THE  FEET. 

imprisoned  within  the  horny  foot  will  cause  acute  pain,  great 
lameness,  violent  febrile  symptoms,  and  even  death  from  pain 
and  nervous  exhaustion ;  or  the  pus  may  extend  upwards 
along  the  lamince,  detaching  the  horny  structures  from  their 
attachments,  finally  appearing  at  the  coronet  as  a  soft  tumour, 
which,  if  pressed  upon,  will  discharge  first  a  sero-sanguineous 
matter  and  pus.  Sometimes  this  discharge  affords  relief,  but 
at  others  the  suppurative  action  extends  round  the  coronet, 
breaking  out  in  various  sinuses  and  unhealthy-looking 
abscesses ;  the  animal  at  the  same  time  suffering  from  a  con- 
tinuation of  the  pain  and  febrile  symptoms,  becomes  rapidly 
emaciated,  and  from  continual  lying  down  covered,  with  bruises 
and  sores. 

To  detect  punctured  wounds  of  the  feet  it  is  necessary  to 
remove  the  shoe  from  the  foot  affected,  then  to  examine  all 
round  the  margin  of  the  sole,  by  pressing  it  and  the  crust  with 
the  pincers.  When  the  seat  of  the  mischief  is  pressed  upon,  the 
horse  will  generally  evince  pain ;  but  the  test  is  not  to  be  de- 
pended upon  until  the  sole  has  been  pared  out. 

"  Pricks  in  shoeing"  usually  manifest  themselves  shortly  after 
the  horse  has  been  shod ;  but  occasionally  there  may  be  no 
signs  for  three  or  four  weeks,  or  even  longer ;  and  in  some  horses, 
especially  if  the  puncture  be  at  the  toe,  the  suppuration  will 
appear  at  the  coronet  as  the  first  symptom  of  mischief.  This 
fact  has  led  some  writers  to  suppose  that,  because  the  burrowing 
of  the  pus  does  no  mischief  in  these  exceptional  cases,  it  is  good 
practice  to  allow  every  case  to  go  on  unchecked,  until  the  pus 
has  forced  its  way  upwards  and  discharged  itself  at  the  coronet. 
I  am  surprised  to  find  that  such  an  idea  has  gained  ground 
latterly,  especially  amongst  the  young  members  of  the  profession. 
It  is  full  of  error,  founded  on  a  very  limited  practical  experi- 
ence, and  calculated  to  entail  much  suffering  on  the  poor  patients, 
and  to  destroy  many  a  valuable  animal's  life.  The  first  step  in 
the  treatment  of  these  accidents  is  to  pare  down  to  the  bottom  of 
the  puncture,  to  allow  the  escape  of  the  matter,  which,  by-the- 
by,  is  generally  of  a  dark  colour,  and  to  place  the  foot  in  a 
poultice.  Many  cases,  if  so  treated,  are  quite  free  from  lame- 
ness in  a  day  afterwards.  A  purgative  is  useful,  removing 
sympathetic  fever. 

Paring  of  the  sole  and  removal  of  the  horn  allow  the  sensi- 


WEAK  FEET.  389 

tive  sole  to  bulge  in  the  form  of  a  fungoid  granulation.  To  this 
caustic  remedies  are  generally  applied.  Such  applications  are, 
however,  calculated  to  do  harm,  as  the  supposed  fungus  is  nothing 
more  than  the  swollen  tissues,  which  disappear  when  the  irrita- 
tion has  subsided,  like  any  other  inflammatory  swelling.  How- 
ever, if,  after  the  subsidence  of  the  lameness  and  inflammation, 
the  bulging  still  continues,  the  nitrate  of  silver  or  sulphate  of 
copper  and  tar  may  be  applied ;  after  which  the  part  ought  to 
be  exposed  to  the  drying  influences  of  the  air,  when  a  scab  will 
form,  affording  a  natural  protection  to  the  tissues,  which  will  now 
soon  heal. 

In  2MTing  and  searcliing  lame  feet,  great  care  is  to  be  taken  not 
to  make  them  bleed,  as  hasmorrhage  obscures  the  operation,  and 
renders  it  a  difficult  matter  to  follow  a  small  spot  of  discoloration 
to  its  termination ;  and  when  the  structures  are  wounded  with 
the  knife,  they  are  apt  to  sprout  up,  inflame,  and  cause  the  healing 
process  to  be  more  prolonged  than  when  the  parts  are  carefully 
pared. 

Two  or  three  sizes  of  "  searches  "  are  very  useful ;  the  smaller 
ones,  with  double-cutting  edges,  to  be  employed  in  the  more 
delicate  and  concluding  part  of  the  operation. 

In  many  cases  of  punctured  foot  it  is  necessary  to  apply  the 
bar  shoe  for  a  few  weeks  in  order  to  remove  the  pressure  from 
the  seat  of  injury,  and  to  diffuse  it  over  the  frog  and  healthy  part 
of  the  foot.     Leather  soles  are  also  useful 


WEAK  FEET. 

Some  horses  have  naturally  weak  feet,  tliin  heels,  and  brittle 
walls,  with  a  tendency  to  split? up  into  layers  where  the  nails  are 
inserted.  These  feet  require  careful  shoeing,  with  stout  shoes, 
and  leather  soles  adapted  to  their  special  peculiarities.  Horses 
that  show  tenderness  or  slight  pain  in  the  feet  after  work  are 
much  relieved  and  benefited  by  having  their  feet  and  legs 
bathed  in  water,  or  by  being  made  to  stand  in  a  foot-bath  for 
one  or  two  hours  at  a  time. 


QUITTOR, 

A  fistulous  wound  upon  the  quarters  and  heels  of  the  coronet^ 


390  DISEASES  OF  THE  FEET. 

generally  caused  by  treads,  pricks  in  shoeing,  suppurating  corns, 
or  any  other  injury  calculated  to  excite  the  suppurative  action 
within  the  foot,  or  in  the  structures  of  the  coronet. 

The  symptoms  of  quittor  are  lameness,  swelling  upon  the 
coronet,  about  the  centre  of  which  one  or  more  small  orifices  are 
seen,  discharging  either  a  thin  limpid  secretion,  or  a  thick,  perhaps 
curdled,  pus.  From  the  external  orifices,  sinuses  are  found 
leading  generally  in  a  downward  direction,  beneath  the  coronary 
substance,  lateral  cartilage,  and  into  the  foot  itself. 

In  many  cases  the  animal  is  excessively  lame,  scarcely  able  to 
put  the  foot  to  the  ground. 

A  quittor  differs  from  a  wound,  or  a  recent  abscess  on  the 
coronet,  by  the  condition  of  the  parts,  which  have  taken  on  a 
peculiar  unhealthy  action,  by  the  character  of  the  surrounding 
swelling,  which  is  hard  to  the  touch,  and  by  the  presence  of 
sinuses. 

The  treatment  will  depend  upon  the  cause.  If  it  be  any- 
thing within  the  foot,  as  a  festered  corn  or  a  prick,  a  depending 
opening  must  be  made  at  the  sole,  sufficiently  large  to  allow  the 
free  escape  of  the  contained  pus.  This,  along  with  poultices  for 
a  few  days,  succeeded  by  a  blister  to  the  enlarged  coronet,  will 
often  be  sufficient ;  the  foot  being  protected  in  the  meantime  by 
a  nicely  adapted  bar  shoe,  if  it  be  too  weak  to  go  without.  In 
all  cases  of  injury  to  the  feet,  I  think  that  if  it  be  possible  to 
do  without  the  shoe  it  is  better  not  to  apply  it ;  but  if  the  foot  is 
broken,  or  if  the  application  of  the  shoe  be  imperative,  a  nicely 
fitted  bar  shoe  can  be  put  on  in  such  a  manner  as  to  remove 
weight  and  pressure  from  the  seat  of  the  injury  or  disease. 

In  cases  of  quittor,  where  no  communication  exists  between 
the  wound  and  the  plantar  surface  of  the  foot,  it  will  be 
necessary  for  the  practitioner  to  introduce  his  probe  carefully, 
and  to  ascertain  the  depth  and  direction  of  the  sinuses ;  when 
he  has  satisfied  himself  on  this  point,  the  Bistouri  cache  (see  Fig. 
76)  is  to  be  introduced  as  deeply  into  the  sinuses'  as  possible. 


Fig.  76. 
the  blade  opened,  and  the  parts  cut  as  it  is  drawn  outwards. 


QUITTORS.  391 

The  ordinary  Bistmiri  cache  will  not  answer  the  purpose,  as  it 
does  not  cut  to  its  point.  The  one  delineated  in  the  woodcut  is 
specially  adapted  for  quittors  and  other  fistulous  sores,  as  it  cuts 
to  its  very  point,  a  matter  of  great  importance  when  it  is  neces- 
sary to  bottom  the  wound.  Very  frequently  the  long  continu- 
ance of  quittor  is  due  to  the  imprisonment  of  a  piece  of  necrosed 
bone,  dead  cartilage,  or  other  foreign  body ;  and  it  will  be  neces- 
sary to  remove  this  before  a  cure  can  be  effected.  When  the 
sinus  has  been  opened  to  its  extremity,  it  is  good  practice  to  inject 
into  it  a  solution  of  the  bichloride  of  mercury,  3i- ;  water,  §i. ; 
a  few  drops  of  hydrochloric  acid  being  added  to  cause  the  salt 
to  dissolve.  One  or  two  injections  of  this  are  sufficient  to 
cause  the  whole  exposed  surface  of  the  wound  to  cast  off  a  thin 
slough,  and  to  leave  a  healthy  granulating  surface,  requiring  no 
treatment  beyond  being  kept  clean.  Much  harm  is  done  in  these 
cases  by  the  long-continued  application  of  escharotics ;  but 
should  the  wound  look  unhealthy  after  the  separation  of  the 
slough,  it  may  be  necessary  to  apply  the  solution  a  second  time. 
A  glass  syringe  is  the  best  instrument,  as  lead  will  be  acted  upon 
by  the  salt  and  the  acid. 

Poultices  assist  the  separation  of  the  slough,  and  tend  to 
soothe  the  irritation.  They  should  therefore  be  applied  for 
several  days. 

In  quittors  of  a  very  intractable  nature  the  whole  diseased 
structures,  including  the  lateral  cartilage,  have  to  be  removed  by 
surgical  operation,  which  is  as  follows  : — The  horse  must  be  cast, 
a  tourniquet  applied  to  the  fetlock;  an  incision  is  then  to  be  made 
at  the  junction  of  the  horny  wall  and  coronary  substance,  im- 
mediately below  the  seat  of  disease,  the  skin  is  to  be  carefully 
dissected  from  the  subcutaneous  structures,  and  folded  upwards 
in  the  form  of  a  flap.  When  this  is  accomplished,  the  diseased 
portions  are  to  be  carefully  removed  with  the  scalpel,  taking  care 
not  to  penetrate  the  articulation,  and  the  skin  brought  back  to 
its  original  position,  and  retained  there  by  firm  but  not  too 
tight  bandages.  If  the  vessels  are  enlarged,  as  sometimes  will 
be  the  case,  they  ought  to  be  secured  by  ligature,  but  generally 
this  is  unnecessary,  the  haemorrhage  being  prevented  by  the 
bandage,  and  it  is  always  better  not  to  introduce  a  foreign  body, 
as  a  ligature,  into  the  wound. 

There  are  many  unqualified  men  noted  for  their  success  in 


392  DISEASES  OF  THE  FEET. 

tlie  treatment  of  quittor.  I  knew  of  one,  and  he  certainly 
managed  to  cure  cases  after  everybody  else  had  failed.  His  plan 
was  a  simple  one,  and  consisted  of  the  injection  of  a  fluid — the 
composition  of  which  was  a  secret — into  the  sinuses  every  four- 
teen days.  He  never  allowed  any  interference  with  the  foot 
during  the  interval,  and  seldom  had  to  apply  his  remedy  more 
than  twice.  I  almost  think  that  it  was  the  tincture  of  the 
terchloride  of  iron.  I  deem  it  advisable,  in  cases  of  quittor,  to 
make  the  incision  into  the  sinus ;  but  there  are  cases  where  these 
care  too  small  and  too  numerous  to  admit  of  a  satisfactory  explora- 
tion. For  such  the  old  plan  of  "  coring  "  will  answer  well,  and 
it  is  as  follows : — Powder  some  corrosive  sublimate,  or  arsenious 
acid,  or  a  mixture  of  both,  very  fine  ;  place  a  very  little  of  the 
powder,  say  five  grains,  on  a  small  square  piece  of  tissue  paper ; 
double  this  up  cornerwise,  and  then  fold  into  a  stiff  plug, 
pointed  at  one  end.  Introduce  it  as  carefully  and  as  deeply 
into  the  wound  as  possible,  and,  if  necessary,  apply  a  bandage 
to  keep  it  in  its  place ;  over  the  whole  apply  a  poultice.  In 
from  five  to  seven  days  a  circular  slough  will  have  separated, 
leaving  the  whole  interior  of  the  wound  exposed  to  view.  If 
this  presents  a  uniform  red  appearance  the  sinuses  have  all  been 
destroyed ;  but  if  pale-looking  spots  or  small  apertures  are  seen 
in  it,  they  indicate  that  more  of  the  diseased  surface  requires 
destruction.  This  should  now  be  carefully  done,  or  the  second 
slough  may  extend  to  important  structures.  When  a  healthy 
surface  has  been  obtained,  and  the  progress  of  the  case  still 
remains  unsatisfactory,  a  blister  must  be  applied  to  the  coronet. 
This  stimulates  the  reparative  process,  and  removes  pain  and 
lameness. 

If  any  part  of  the  crust  should  at  any  time  press  upon  the 
textures  involved  in  the  diseased  action,  it  is  to  be  carefully 
thinned  by  the  rasp.  To  sum  up,  the  principles  of  treatment  are 
as  follows : — To  make  a  depending  orifice  by  incision,  seton,  or 
counter-opening,  by  seton  or  cautery  remove  all  foreign  bodies, 
to  destroy  unhealthy  surfaces,  allay  irritation,  and  finally  to 
stimulate  the  reparative  process. 

The  vital  powers  and  vascularity  of  the  several  structures 
involved  vary  to  a  great  extent ;  hence  the  practitioner  some- 
times finds  that,  after  doing  all  he  can,  the  case  progresses 
unsatisfactorily.    I  have  in  such  instances  found  it  advantageous 


QUITTORS.  393 

to  apply  the  actual  cautery  to  the  diseased  structures,  making  a 
pointed  iron,  and  pushing  it,  at  a  white  heat,  to  the  very  bot- 
tom of  the  sinuses.  The  results  from  this  have  been  satisfactory; 
the  lameness  has  been  relieved,  the  swelling  removed,  and 
healthy  action  set  up  in  the  wound. 

When  fistulous  openings  are  situated  upon  or  near  to  the 
anterior  surface  of  the  coronet,  great  care  and  discrimination  must 
be  brought  to  bear  upon  their  treatment,  as  the  pedal  articula- 
tion is  there  superficially  seated  and  thinly  covered  by  soft 
structures,  and  a  free  application  of  an  escharotic  is  sure  to 
cause  the  slough  to  extend  into  the  joint. 

No  horse  should  work  while  suffering  from  quittor,  as  it  not 
only  causes  great  suffering  to  the  poor  animal,  but  renders 
recovery  almost  an  impossibility. 


FOUL  IN  THE  FOOT 

Is  a  disease  of  horned  cattle,  and  consists  of  inflammation  and 
suppuration  of  the  inter-digital  substance,  caused  by  over- 
growth of  the  hoof,  which  when  elongated  gives  rise  to  strain 
and  inflammation  of  the  internal  structures,  the  irritation  of  dirt 
confined  between  the  digits,  and  in  some  instances  tuberculosis. 
It  extends  by  neglect  or  other  causes  into  the  various  articula- 
tions and  bones  of  the  foot,  producing  great  lameness,  with  much 
fever,  loss  of  condition,  and  even  death.  It  is  most  commonly 
seen  in  the  hind  feet,  but  it  is  not  unusual  to  meet  with  it  in 
the  fore  feet. 

In  the  majority  of  cases,  if  not  caused  by  tubercular  inflam- 
mation (see  page  208),  the  disease,  if  attended  to  in  time,  is  not 
so  difficult  to  manage ;  the  treatment  being  the  careful  removal  of 
all  loose  horn  under  which  pus  is  seen  to  burrow,  mild  astrin- 
gents, poultices,  and  a  purgative.  In  the  more  severe  cases, 
where  the  inter-digital  substance  undergoes  sloughing,  the  pro- 
cess must  be  assisted  by  warm  poultices  and  fomentations. 
Afterwards  the  wound  must  be  treated  with  astringents,  great 
cleanliness,  and  protected  by  nice  pledgets  of  tow  steeped  in  a 
weak  solution  of  carbolic  acid,  kept  in  their  position  by  carefully 
adjusted  bandages.  There  are  other  cases  where  the  phalangeal 
bones  are  involved  as  high  as  the  fetlock,  with  hard  swelling  of 
all  the  tissues,  separation  of  the  digits  by  enlargement  of  the 


394  DISEASES  OF  THE  FEET. 

inter-digital  substance,  dislocation  of  the  inter-phalangeal  articu- 
lations, caries  of  the  articular  extremities  of  the  bones,  synovial 
discharge,  necrosis  of  the  canons,  great  suffering,  and  lameness. 
Cattle,  when  so  sorely  troubled,  will  lie  down,  groan  with  pain, 
and  refuse  to  feed,  the  flesh  quickly  wasting ;  great  sores  appear 
upon  the  various  parts  of  the  body  on  which  they  lie;  and  many 
will  give  up  the  battle  altogether,  and  die  right  away  as  if  their 
hearts  were  broken.  Now,  in  such  cases,  whether  the  cause  be 
tubercular  deposition  or  not,  the  only  method  of  cure  is  by 
amputation  or  disarticulation.  I  have  performed  these  opera- 
tions with  the  greatest  success,  and  I  am  thus  in  a  position  to 
suggest  the  best  method. 

If  the  disease  has  not  yet  extended  above  the  metacarpo- 
phalangeal articulation,  the  foot  and  pastern  may  be  removed 
by  disarticulation  tlirough  the  fetlock-joint;  but  if  this  joint 
be  involved  to  any  considerable  extent,  it  will  be  necessary  to 
amputate  through  the  canon  bone.  The  operation  is  as  follows: 
— Before  the  animal  is  cast,  the  diseased  limb  must  be  protected 
by  a  bandage,  and  when  the  animal  is  down  removed  from  the 
casting  rope,  fastened  by  a  cord  tied  around  the  pastern,  and 
held  in  position  by  two  assistants ;  a  tourniquet  is  then  to  be 
applied  above  the  seat  of  the  intended  section.  The  knife  must 
be  strong,  with  a  narrow  blade ;  and  care  is  to  be  taken  that 
sufficient  skin  be  left  to  form  a  good  flap,  so  that  the  exposed 
end  of  the  bone,  as  well  as  the  soft  parts,  be  completely  covered 
when  the  edges  of  the  wound  are  brought  together.  When  the 
bone  has  been  removed,  the  arteries  are  to  be  carefully  taken  up 
and  secured  by  ligatures,  and  the  whole  extremity  of  the  limb 
afterwards  enveloped  in  carbolized  lint  or  fine  tow,  firmly,  but 
not  too  tightly,  bound  with  a  bandage.  If  the  discharge  is  not 
very  profuse,  little  after  treatment  is  required,  beyond  cleanli- 
ness and  occasional  readjustment  of  the  dressings.  The  animal 
must  be  well  supported  with  nutritious  food,  and  prepared  for 
the  butcher  as  quickly  as  possible. 

Tumours  between  the  claius  of  Cattle. — Hard  nodules  sometimes 
grow  from  the  skin  between  the  digits,  causing  a  varying  degree 
of  lameness.  They  should  be  removed  with  the  scalpel  as  early 
as  possible. 


rOOT-KOT  IN  SHEEP.  395 


FOOT-ROT  m   SHEEP. 

There  are  few  diseases  upon  the  nature  and  causes  of  which 
so  much  difference  of  opinion  exists  as  upon  this  troublesome 
and  vexatious  source  of  loss. 

Continental,  as  well  as  some  English  and  American  veterinary- 
writers  and  observers,  divide  foot-rot  into  two  varieties,  namely, 
contagious  and  non-contagious. 

The  first  or  contagious  form  is  called  by  a  variety  of  names, 
as  Paronchyia  ungularis  ovium  maligna  or  contagiosa  (Latin) ; 
Fietin,  Pietin  contagieux,  Mai  de  pied,  &c.  (French) ;  Bosartige 
Klaueseuche  der  Schafe,  &c.  (German) ;  and  the  latter,  Paronchyia 
inter-digitalis,  or  gravelling. 

Mr.  George  Fleming  is  the  latest  writer  upon  the  subject,  who 
has  re-opened  the  question  of  the  contagiousness  of  foot-rot,  and 
in  his  work  on  Veterinary  Sanitary  Science  and  Police  brings 
forward  the  opinions  of  Gohier,  Chaumontel,  Gasparin,  Girard, 
Eeynal,  Eandall  (an  American  writer),  and  others,  in  support  of 
its  contagiousness  ;  but  he  seems  to  have  passed  over  the  deduc- 
tions of  English  writers  for  and  against  this  hyothesis.  Hogg, 
the  Ettrick  Shepherd,  in  his  prize  essay,  communicated  to  the 
Highland  and  Agricultural  Society  of  Scotland,  was  a  firm 
believer  in  its  contagiousness.  Youatt  seems  to  be  uncertain 
upon  the  matter.  Professor  Brown,  in  an  able  essay  published 
in  the  Journal  of  the  Bath  and  West  of  England  Society,  as  well 
as  Professor  Dick,  unhesitatingly  state  that  it  is  a  non-contagious 
disease. 

In  his  lectures  Professor  Dick  said  as  follows : — "  Foot-rot  is 
the  name  given  to  a  disease  in  sheep  similar  to  '  Foul  in  the 
foot'  of  horned  cattle.  Its  consequences  are  disastrous  and 
ruinous,  attacking,  if  neglected,  the  whole  flock,  so  that  in  feed- 
ing they  actually  crawl  on  their  knees ;  hence  it  is  regarded  in 
the  last  degree  contagious.  After  a  good  deal  of  investigation, 
however,  I  have  arrived  at  a  different  conclusion;  and  I  discover  in 
its  history  nothing  more  than  the  result  of  that  domestic  state  to 
which  the  sheep  has  been  subjected.  By  nature  not  unlike  the 
goat,  it  frequents  the  summits  of  the  lofty  mountains,  where  its 
hoofs,  altogether  analogous  to  those  of  the  horse,  are  exposed  to 
much  tear  and  wear.  When  from  these  alpine  regions  we 
transfer  the  sheep  into  our  grassy  lawns,  our  moorish  lands,  or 


396  DISEASES  OF  THE  FEET. 

sandy  soils,  tins  wearing  away  of  the  crust  is  put  an  end  to ; 
it  grows  too  long,  and  proves  a  great  encumbrance.  In  this 
state  it  is  exposed  to  many  injuries,  among  others  from  the  long 
grass  of  the  pastures,  and  itself  necessarily  injures  the  soft  parts 
beneath ;  and  hence  lameness,  inflammation,  suppuration,  to  the 
extent  of  casting  the  hoof,  are  the  consequences.  The  circum- 
stance of  the  disease  occurring  epidemically  arises  from  the 
whole  flock  being  placed  in  precisely  similar  circumstances." 

The  late  Mr.  Eead  of  Crediton,  in  an  essay  on  this  subject,  after 
very  carefully  weighing  for  and  against  contagiousness,  says : — - 
"  For  the  last  three  or  four  years  I  have  made  every  inquiry 
of  men  accustomed  to  sheep.  Some  say,  on  my  asking  their 
opinion,  that  it  is  as  infectious  as  the  plague ;  for  if  they  put  a 
lot  of  sound  ones  with  some  that  were  lame,  they  all  became  so. 
But  I  have  said — '  Perhaps  the  sheep  with  whom  yours  were 
put  were  in  a  soil  favourable  to  the  production  of  foot-rot,  and 
yours  were  taken  from  a  healthy  soil.'  Such  was  generally  the 
case,  and  such  is  the  proof  which  farmers  and  others  pretend  to 
give  of  its  infectious  nature.  Little  do  they  imagine  what  is 
the  operating  cause  on  a  soil  disposed  to  it.  That  which  gives 
it  to  one  will  give  it  to  a  hundred  if  there  is  a  predisposition  to 
take  it  on." 

"  My  opinion  is,"  concludes  Mr.  Read,  "  that  you  may  put 
lame  sheep  with  sound  ones  on  a  healthy  farm,  and  they  will 
soon  get  well,  and  the  others  will  not  become  infected." 

Mr.  George  Fleming  brings  forward  some  very  strong  facts  in 
support  of  its  contagious  nature,  and  under  the  head  of  "  Con- 
tagium,"  says  as  follows: — "  The  contagium  is  present  in  the 
exudation  from  the  diseased  foot,  and  may  be  termed  '  fixed.* 
It  is  transmissible  either  directly  through  contact  of  the  diseased 
with  healthy  sheejD,  or  indirectly  through  litter,  pastures,  roads, 
railway  waggons,  or  cattle  ships.  It  is  also  transmissible  by 
'  inoculation '  of  the  morbid  fluid  at  the  coronets  of  healthy 
sheep.  Indeed,  though  numerous  observations  had  previously 
demonstrated  that  the  extension  of  the  malady  was  due  to  the 
presence  of  a  virulent  element,  it  was  not  until  inoculation  was 
resorted  to  that  this  was  received  as  a  fact.  Pictet  was  the  first 
(in  1805)  to  publish  observations  in  this  direction.  He  received 
two  hundred  half-bred  merino  sheep  from  Piedmont,  some  of 
which  were  lame  from  the  disease.     These  were  placed  with  a 


FOOT-EOT  IN  SHEEP.  397 

hundred  other  home  sheep  on  a  low  hill,  wher6  the  pasture  was 
dry  and  of  good  quality;  but  in  a  short  time  the  latter  com- 
menced to  have  sore  feet,  and  before  long  the  whole  three 
hundred  were  affected.  The  rams,  which  joined  them  after- 
wards, were  also  attacked.  This  occurrence  having  been  made 
public,  attention  was  directed  to  the  contagiousness  of  the 
malady,  and  similar  occurrences  were  soon  made  known,  espe- 
cially by  Girard.  Gohier,  to  decide  the  question,  undertook  a 
series  of  experiments,  after  having  published  confirmative  obser- 
vations. He  removed  shreds  of  the  loose  horn  from  the  claws 
of  diseased  sheep,  and  fastened  them  between  those  which  were 
quite  healthy;  in  this  way  he  produced  the  malady.  As  the 
question  was  a  serious  one  for  the  agricultural  interest  of  France, 
the  Agricultural  Society  of  Paris  offered  premiums  for  the  best 
essay  on  the  disease,  and  these  were  awarded  (in  1823)  to  Favre 
and  Sorillon.  The  experiments  successfully  carried  out  by  these 
authorities  were  perfectly  conclusive.  Favre,  for  instance,  in  one 
of  his  trials,  simply  deposited  the  matter  between  the  toes  of 
thirty-two  sheep,  and  twenty-one  became  affected.  Then  followed 
observations  and  experiments  by  Letzius,  Giesker,  Felix,  Mathieu, 
Delafond,  Charlier,  and  others.  Eeynal  has  made  numerous 
observations  and  direct  experiments,  which  are  entirely  confirma- 
tive of  all  that  had  been  previously  published ;  so  that  there  is 
no  doubt  whatever  as  to  the  existence  of  a  virulent  element  in 
the  disease,  and  that  to  this  it  largely  owes  its  extension. 

"  Vitality  of  the  Virus. — The  virus  of  foot-rot  appears  to 
preserve  its  activity  for  a  considerable  period,  though  nothing 
definite  has  yet  been  arrived  at  in  this  respect. 

"  Infection. — The  virus  does  not  appear  to  have  any  influence 
on  other  animals  than  sheep ;  no  case  of  transmission,  either 
naturally  or  by  inoculation,  having  been  recorded.  Fine-wooled, 
high-bred  sheep,  as  already  noticed,  are  most  readily  infected, 
and  lambs  are  also  susceptible ;  those  with  coarse  wool  are  not 
only  less  readily  infected,  but  they  are  more  easily  cured. 

"  The  power  of  the  infection  is  shown  in  Favre's  experiments, 
in  which  twenty-one  out  of  thirty-two  inoculated  sheep  become 
affected. 

"  Mode  of  Access. — Infection  takes  place  through  the  skin 
around  the  claws.  There  is  no  evidence  to  show  that  it  can 
be  produced  in  any  other  manner. 


398  DISEASES  OF  THE  FEET. 

"  Incubation. — The  incubation  stage  is  from  three  to  six  days. 

"  Extension. — The  disease  is  chiefly  extended  through  traffic 
in  sheep  at  the  fairs  and  markets;  by  allowing  diseased  animals 
to  travel  in  railway  waggons  and  ships,  and  introducing  healthy 
stock  into  these  without  a  thorough  cleansing  having  been 
carried  out.  Pastures  on  which  affected  sheep  have  grazed  a 
short  time  previously  have  also  been  known  to  cause  the  disease 
in  flocks  succeeding  them.  Indeed,  we  can  scarcely  realise  any 
more  certain  mode  of  extension  than  that  of  depasturing  healthy 
sheep  with  diseased,  or  where  the  latter  have  been  a  short  time 
before.  The  grass  imbibes  the  discharge  from  the  suppurating 
claws,  and  especially  from  between  them,  where  it  is  most 
abundant  and  virulent ;  and  the  healthy  sheep,  walking  through 
the  grass,  must  receive  continuous  applications  of  the  virus  from 
every  blade,  and  on  the  very  part  where  experiments  have 
proved  the  skin  to  be  most  prompt  and  certain  in  absorbing  it 
— between  the  toes. 

"  Contact  between,  or  mixing  of,  the  sick  and  healthy,  even  for 
a  brief  period,  on  roads,  at  fairs,  or  on  pastures,  is  also  a  prolific 
cause  of  extension.  Litter,  fodder,  sheds,  and  stables  must  also 
be  included  among  the  media  which  harbour  and  convey  the 
contagion.  As  has  been  remarked,  the  extension  is  facilitated 
by  certain  external  influences." 

I  have  inserted  these  quotations  in  order  that  the  reader  may 
have  both  sides  of  the  question. 

I  think,  however,  that  the  direct  inoculation,  by  means 
of  shreds  of  loose  horn  or  matter  from  diseased  feet  applied 
between  the  claws  of  feet  that  were  healthy,  proves  nothing 
further  than  that  discharge,  in  virtue  of  its  imtating  properties, 
induced  inflammation  of  the  inter-digital  tissues  in  a  manner 
similar  to  that  which  would  result  from  the  application  of  any 
common  irritant,  or  even  a  foreign  body,  applied  to  and  retained 
in  the  same  place,  and  that  the  other  facts  are  incomplete,  as  it 
is  not  stated  whether  the  season  was  damp  or  dry.  Professor 
Brown's  opinion  upon  this  question  is  well  worth  quoting. 
He  says: — "  The  third  position  which  we  have  undertaken  to 
discuss  will  require  but  little  consideration.  It  refers  to  the 
*  virus '  of  '  foot-rot,' — the  animal  poison  supposed  to  be  capable 
of  inducing  the  disease  by  contact. 

"  The  question  of  the  existence  of  such  poison  among  the  pro- 


FOOT-ROT  IN  SHEEP.  399 

ducts  of  foot-rot  must  be  determined  by  experiment;  and  the 
only  foundation  for  the  assumption  of  '  virus '  lies  in  the  fact 
that  the  introduction  of  the  matter  from  a  diseased  foot  to  the 
healthy  foot  by  puncture  through  the  horn  has  produced  foot-rot 
in  some  cases,  although  it  has  failed  to  do  so  in  others. 

"  After  all,  the  fact  may  be  admitted  without  any  question ; 
it  proves  very  little.  We  are  quite  prepared  to  learn  that  an 
injury  to  the  horn  of  the  foot,  followed  by  the  contact  of  a  mix- 
ture of  moist  epithelial  cells  and  particles  of  dirt,  will,  if  applied 
sufficiently  long,  produce  foot-rot;  we  know  that  dirt  and  moisture 
will  suffice,  without  any  additional  elements. 

"  Some  of  the  experiments  in  inoculation  failed,  probably 
because  there  did  not  happen  to  be  enough  of  the  gritty  particles; 
others  because  they  did  not  remain  long  enough  in  contact  with 
the  membrane  to  establish  any  irritation ;  and  at  best  there 
was  not  so  much  disease  produced  as  would  have  occurred  if 
the  animals  had  been  placed  upon  undrained  land,  where  there 
happened  to  be  a  tolerably  plentiful  admixture  of  sand  or  grit 
in  the  soil. 

"  If  it  had  ever  been  found  that  the  introduction  of  the 
matter  under  the  skin  of  the  leg  or  any  part  of  the  body  pro- 
duced the  disease,  there  would  be  fair  evidence  of  its  specific 
nature;  but  in  the  absence  of  this  proof,  we  cannot  admit 
an  assumption  which  is  altogether  unnecessary  to  explain  the 
results. 

"  From  the  present  state  of  the  argument,  we  may  consis- 
tently deduce  the  conclusion  that '  foot-rot '  is  primarily  con- 
sequent upon  such  a  derangement  of  the  structure  of  the  horn 
as  permits  the  introduction  of  foreign  particles,  which  ultimately 
reach  the  internal  membrane,  and  occasion  irritation,  followed 
by  exudation  and  excessive  secretion." 

For  some  time  past  my  attention  has  been  very  much  directed 
to  this  matter,  and  from  my  own  observations,  very  carefully 
made,  and  from  information  gathered  from  many  eminent  flock- 
masters  and  their  shepherds,  I  am  quite  satisfied  that  diseased 
sheep  may,  without  fear  of  infection,  be  allowed  to  mix  with 
sound  ones  on  dry  lands,  and  that  consequently  foot-rot  is  a 
non-contagious  malady,  and  that  it  is  manifested  in  two  ways. 
First.  Sheep  pastured  on  gravelly  or  sharp  sandy  farms,  wear 
away,  especially  in  wet  weather,  the  soles  of  their  hoofs,  and 


400: 


DISEASES  OF  THE  FEET. 


the  sensitive  parts  become  exposed;  or  if  pastured  on  moor- 
lands, or  soft  parks,  the  wall  grows  too  long,  the  sole,  changed 
by  moisture,  affords  but  an  imperfect  protection  to  the  sensitive 
structure  within,  permits  the  penetration  of  dirt,  and  occasion- 
ally, as  stated  by  Professor  Dick,  the  toe  of  one  or  both  claws  may 
bend  upon  the  sole,  and  thus  become  a  source  of  pain  and  infiam- 
mation.  Fungoid  growths  appear  on  the  exposed  surfaces,  the 
lameness  increases,  and  there  is  loss  of  condition,  as  in  the  ether 
form  of  the  disease. 


Fig.  77. — Confirmed  stage  of  the  first  form  of  foot-rot. 

The  second  and  by  far  more  common  form  of  foot-rot  is  ex- 
pressed by  inflammation  and  swelling  of  the  inter-digital  tissues, 
with  at  first  but  little  visible  alteration  in  the  condition  of  the  horny 


Fig.  78  shows  the  condition  of  internal  wall  of 
digit  in  an  early  stage  of  the  disease. 

sole,  but  the  inflamed  inter-digital  structures  soon  suppurate,  and 
discharge  a  foetid  ichorous  fluid,  which  burrows  under  the  horn  of 


FOOT-ROT  IN  SHEEP.  401 

the  inner  walls  of  the  claws,  and  separates  it  from  the  sensitive 
structures  within  ;  as  in  the  other  form,  the  exposed  structures 
soon  sprout,  forming  fungoid  growths,  which  discharge  a  little 
foetid  ichor. 

The  lameness  increases  in  severity  as  the  disease  advances, 
and  in  a  few  days  the  animal  presents  a  lank  appearance,  and 
begins  to  lose  condition. 

In  some  cases  the  sensitive  structures  of  the  affected  foot  or 
feet  lose  their  cohesion,  and  the  horny  walls  hang  loose  around 
them,  separated  from  the  inflamed  tissues  within,  except  at  the 
upper  edge  of  the  foot.  The  horny  sole  crumbles  away  as  seen 
in  Fig.  77,  the  sensitive  tissues  are  exposed,  and  soon  sprout  as 
masses  of  fungus.  The  animal  is  now  unable  to  put  its  lame 
feet  to  the  ground,  and  will  crawl  on  its  knees,  if  the  fore  feet 
only  be  affected,  and  upon  its  abdomen,  if  the  hind  ones  be  the 
seat  of  the  disease. 

If  the  hoofs  are  not  shed,  it  is  found  that  the  continual  irri- 
tation gives  rise  to  an  augmented  but  intermitting  secretion  of 
horn,  the  hoof  becomes  crooked,  hard,  deformed,  large  in  size, 
and  covered  with  rings. 

The  disease — ^like  that  described  by  Mr.  Fleming — "  affects 
one  or  more  feet;  but  ordinarily  one,  and  passes  to  the  others;" 
but  sometimes  only  a  single  claw  is  affected. 

It  is  important  that  the  differential  symptoms  of  foot-rot  and 
foot-and-mouth  disease  in  sheep  be  correctly  understood. 

From  what  has  been  stated,  foot-rot  commences  either  upon 
the  solar  aspect  of  the  foot  or  in  the  inter-digital  tissues.  In  the 
one  case  it  begins  below,  in  the  other  above;  and  by  diffusion  of 
the  inflammation  and  burrowing  of  the  pus  extends  along  the 
inner  aspect  of  the  digits  downwards  to  the  sole,  and  sometimes 
upwards  through  the  coronary  structures,  forming  sinuses  and 
ulcers  above  the  hoof,  occasionally,  but  very  rarely,  involving 
the  tendons  and  bones,  and  causing  sloughing  of  the  whole  foot, 
there  being  at  all  times  a  strong  tendency  to  the  gxowth  of 
fungus  from  every  exposed  part  of  the  foot. 

Now,  in  foot-and-mouth  disease — eczema  contagiosa — the 
local  symptoms  are  first  manifested  by  redness  of  the 
skin  surrounding  the  coronet,  this  redness  commencing  very 
often  as  a  mere  spot  exactly  above  the  inter-digital  space, 
particularly  at   the   heels,  then  extending  all  round  the  coro- 

2d 


402 


DISEASES  OF  THE  FEET. 


net  and  on  the  pastern;  the  redness  is  succeeded  by  an  erup- 
tion, the  crop  of  pimples  or  vesicles  being  generally  more 
numerous  above  the  bulbs  of  the  heels.  The  eruptive  stage 
does  not  continue  long,  the  blisters  burst  or  dry  up  and  form 
a  layer  of  scabs,  which  finally  fall  off  or  dessicate,  leaving 
the  parts  more  or  less  denuded  of  wool  for  some  time  subse- 
quently ;  indeed  it  may  be  stated  that  the  condition  of  the  coro- 
nary skin  is  very  similar  to  that  which  is  induced  by  the  action 
of  an  ordinary  cantharides  blister,  and  the  changes  occurring  on 
the  skin  of  the  coronet  may  be  classified  under  four  heads, 
namely,  redness,  vesication,  scab,  and  dessication. 

The  inflamed  and  vesicular  condition  of  the  skin  is  thought  by 
some  observers  to  extend  into  the  sensitive  foot,  and  no  doubt  this 
is  a  correct  and  proper  view  to  take  of  the  disease,  .and  accounts 
for  the  very  severe  lameness  observable  in  the  earlier  stages, 
the  early  detachment  of  the  horny  digits  from  their  connecting 
laminae,^  and  for  the  presence  of  lameness  in  some  instances 
before  the  occurrence  of  perceptible  redness  of  the  coronary  sub- 
stance.    Immediately  on  the  appearance  of  vesication,  and  some- 


FiG.  79  shows  the  condition  of  a  foot  four  weeks  after 
the  first  or  febrile  stage. 

times  even  prior  to  that  event,  the  horny  walls  separate,  more 
particularly  at  the  posterior  part  of  the  feet,  sometimes  yerj 
slightly,  occasionally  a  mere  line  of  attempted  separation  being 
observable,  at  other  times  more  completely,  from  their  attach- 

*  Vesication  round  the  coronet  should  not  necessarily  produce  separation  of  the 
horn  therefrom ;  nor  does  it,  unless,  as  in  eczema  cpizootlca,  where,  in  even 
Blight  cases,  the  vesicles  will  be  found  to  extend  underneath  the  coronarj'  band. 


FOOT-EOT  IN  SHEEP.  403 

ments  to  the  coronary  substance,  or,  where  the  attack  has  been 
violent,  from  the  connecting  laminse  also,  and  thus  the  horny 
digits  are  more  or  less  completely  separated  from  the  sensitive 
and  vascular  structures  within ;  and  in  a  varying  period,  depend- 
ing on  the  severity  of  the  attack,  the  claw  can  be  pulled  off  with 
ease,  or  is  cast  off  spontaneously,  leaving  the  exposed  living 
structures  smooth,  red,  and  congested,  and  now  of  course  liable 
to  be  affected  by  external  irritants,  and  to  sprout  up  in  the  form 
of  fungoid  granulations,  and  thus  may  be  confounded  with  foot- 
rot  by  inexperienced  persons.  Eeference  to  page  401  will  sliov/ 
that  even  in  the  worst  forms  of  foot-rot,  where  the  horn  is  de- 
tached from  the  sensitive  foot,  that  it  still  remains  attached  at 
its  upper  border.  Now,  in  foot-and-mouth  disease,  the  separa- 
tion always  commences  at  the  coronary  junction. 

Professor  Brown  says—"  Of  the  several  quite  distinct  local 
diseases  of  the  foot  of  the  sheep,  none  is  distinguished  by 
the  presence  of  a  blister  or  vesicle  in  any  part  of  the  foot, 
while  in  the  foot-and-mouth  disease  there  are  always  vesicles 
present,  or  distinct  evidence  of  their  previous  existence,  and 
there  is  also  a  general  absence  of  that  condition  of  hoof  which 
is  usual  in  foot-rot.  In  exceptional  cases  the  hoofs  are  elon- 
gated, much  broken,  and  sometimes  ragged  and  rotten;  but  this 
condition  has  nothing  to  do  with  the  aphthous  disease,  which  is 
indicated  by  the  presence  of  vesicles  between  the  claws,  in  the 
posterior  part  of  the  foot  immediately  above  the  hoof,  and 
sometimes  exactly  on  the  portion  of  skin  between  the  digits 
which  covers  the  transverse  ligament  connecting  the  two  sides 
of  the  foot  together,  and  which  is  rendered  tense,  and  therefore 
distinct  Avhen  the  digits  are  pulled  apart.  When  the  posterior 
part  of  the  hoof  is  separated  from  the  secreting  membrane,  as  it 
often  is  in  foot-and-mouth  disease,  the  vascular  surface  is  seen 
to  be  congested,  but  there  are  no  signs  of  the  so-called  fungoid 
growths  which  distinguish  foot-rot.  In  short,  no  two  diseases 
can  be  more  distinct  from  each  other  in  the  local  appearances ; 
but  independently  of  the  evidence  afforded  by  the  diseased  parts, 
there  is  in  cases  of  foot-and-mouth  disease  clear  evidence  of 
febrile  action  in  the  system.  The  animal's  appetite  may  not 
be  much  affected,  nor  is  it  necessary  that  the  demeanour  should 
be  suggestive  of  much  suffering,  but  the  application  of  the 
tliermometer  will  show  a  rise  of  internal  temperature  when  the 


404  DISEASES  OF  THE  FEET. 

animal  is  suffering  from  the  aphthous  affection.  Making  allow- 
ances for  the  variations  of  the  temperature  in  sheep,  which 
in  health  will  range  from  101°  to  104°,  the  increase  is  quite 
marked,  as  the  temperature  in  the  diseased  sheep  will  range  from 
104°  to  107°.  It  will  not,  however,  in  the  majority  of  cases,  be 
necessary  to  use  the  thermometer  to  decide  the  question  of  the 
nature  of  the  disease,  as  the  local  evidence  will  be  sufficient. 

"  Vesicles  in  the  mouth  of  the  sheep,  although  not  so  generally 
present  as  in  cattle,  are  very  commonly  found  when  they  are 
looked  for,  but  as  the  idea  has  long  been  prevalent  that  sheep 
are  not  affected  in  the  month,  it  naturally  has  happened  that 
the  part  has  escaped  notice,  and  besides,  the  lesion  is  not  so 
prominent  as  in  the  mouths  of  cattle,  and  therefore  not  so  readily 
recognised  by  the  unpractised  eye.  In  lambs  of  a  few  weeks 
old  vesicles  not  larger  than  a  hemp  seed  have  been  detected  on 
the  tongue.  Abrasions  on  the  lips  and  palate  are  frequently 
seen  in  sheep  identical  in  character  with  those  which  are  ob- 
served in  cattle ;  and  altogether  the  evidence  of  the  identity 
of  the  disease  in  cattle  and  sheep  is  perfectly  conclusive,  even 
irrespective  of  the  admitted  fact  that  the  affection  is  inter- 
communicable  in  the  two  classes  of  animals." 

Professor  Brown  states  that  vesicles  in  the  mouth  are  very 
commonly  found  when  they  are  looked  for.  My  experience 
leads  me  to  a  different  conclusion,  namely,  that  during  some  out- 
breaks they  are  as  often  absent  as  present,  even  in  the  earliest 
stage  of  the  disease. 

In  addition  to  the  fever  expressed  by  increased  temperature, 
acceleration  of  the  respiratory  movements,  sinking  of  the  flank 
and  belly — "  clapping,"  as  it  is  called  in  Scotland — and  loss  of 
appetite,  which  precedes  and  accompanies  the  earliest  local 
manifestation  of  foot-and-mouth  disease,  another  important 
difference  exists,  namely,  the  lameness  of  foot-rot  very  com- 
monly commences  in  one  or  two  of  the  feet,  and  may  or  may 
rot  pass  to  the  others ;  whereas  in  foot-and-mouth  disease  all 
the  feet  may  be  simultaneously  affected,  in  which  case  the 
animal  creeps  in  a  very  characteristic  manner  when  first  made 
to  rise  from  the  recumbent  posture.  In  some  instances  all 
the  feet  may  not  be  affected,  or  some  may  suffer  more  severely 
tlian  others ;  in  whichever  it  is  manifested,  the  lameness  does 
not  affect  the  feet  consecutively  as  in  foot-rot. 


TOOT-ROT  IN  SHEEP.  405 

Causes  of  Foot-Rot— Ali\io\\g\i  it  is  ascertained  that  the  tend- 
ency to  foot-rot  may  be  hereditary,  and  the  progeny  of  some  sheep 
of  all  breeds  are  more  liable  to  it  than  others  on  the  same  farm,  it 
must  be  confessed  that  the  great  cause  of  foot-rot  is  wet,  causing 
softening  of  the  horn.  Where  the  grass  is  long  and  insinuates  itself 
between  the  claws,  the  part  of  the  upper  and  thin  portion  of  the 
inner  walls  of  the  digits  is  the  first  to  give  way,  and  the  disease 
may  be  said  to  be  inter-digital,  and  is  called  the  scald  in  some  dis- 
tricts ;  but  where  the  grasses  are  short,  mossy,  and  the  soil  sandy, 
the  solar  aspect  of  the  foot  is  the  first  to  suffer.  Wliichever 
way  it  is  first  manifested  it  is  entirely  due  to  wet  soil,  and  in 
its  prevention  and  cure  this  fact  must  be  borne  in  mind. 

On  hill  farms  it  is  found  that  this  disease  appears  almost  in- 
variably about  the  end  of  July,  and  reaches  its  height  towards 
the  end  of  August  and  beginning  of  September.  During  this 
period  the  dews  are  heavy,  and  the  grasses  consequently  satu- 
rated with  moisture. 

Prevention. — "  The  prevention  of  foot-rot,"  says  Mr.  Armatage, 
**  is  a  subject  which  should  engage  more  attention  than  it  has  up 
to  the  present  time." 

Of  course  it  will  be  understood  that  removal  from  a  wet  to 
dry  sound  pasture  is  of  pre-eminent  importance,  and  from  luxu- 
riant to  a  shorter  kind  of  grass.     In  highly  cultivated  farms  the 
removal  of  sheep  from  luxuriant  pasturage  is  often  a  matter  of  im- 
possibility;  when  such  is  the  case,  experiments  have  been  tried  to 
harden  the  hoofs  of  the  sheep,  that  they  might  resist  the  action  of 
moisture,  and  some  of  these  have  been  to  some  extent  successful. 
The  Messrs.  Archibald  of  Overshiels,  Glengelt,  Duddingstone, 
&c.,  the  celebrated  breeders  of  blackface  and  Cheviots,  inform  me 
that  they  have  found  the  following  process  superior  to  all  others: — 
A  wooden  trough  of  the  following  dimensions  is  to  be  made. 
Length  nine  feet,  breadth  two  feet,  and  depth  one  foot  and  a 
half,  with  lid  and  lock,  in  order  that  it  may  be  locked  after  it  has 
been  used.     Into  this  trough  a  solution  of  arsenious  acid  of  the 
following  strength  is  to  be  poured,  sufficiently  deep  to  cover 
the  feet  of  sheep  as  they  are  driven  through  it,  namely,  one 
pound  of  the  arsenic  to  five  gallons  of  water. 

Arsenic  of  itself  is  but  slightly  soluble  in  water,  and  in  order  to 
dissolve  it  readily,  it  is  necessary  to  combine  it  with  an  equal  quan- 
tity of  an  alkali,  such  as  the  common  washing  soda.    The  arsenic 


406  DISEASES  OF  THE  FEET. 

and  the  alkali  should  be  put  in  boiling  water  together,  in  a  boiler 
large  in  proportion  to  the  quantity  of  water  it  iy  to  contain,  and 
for  the  reason  that  the  liquid  is  apt  to  rise  suddenly;  the  carbonic 
acid,  combined  with  the  alkali,  is  disengaged  by  the  process  of 
boiling,and  during  its  escape  causes  rapid  ebullition.  For  thesame 
reason  the  water,  after  the  addition  of  the  powder,  niust  be  slowly 
boiled  for  some  time,  or  until  the  arsenic  is  entirely  dissolved. 

The  sheep  are  to  be  driven  through  the  trough  containing 
the  arsenical  solution  once  a  week ;  if  it  is  thought  necessary  to 
repeat  it  oftener,  the  liquid  is  to  be  weakened  in  strength  by  tlie 
addition  of  water. 

To  prevent  the  sheep  jumping  out  of  the  trough  as  they  are 
being  driven  through,  it  it  will  be  necessary  to  place  hurdles  at 
the  sides;  and  it  is  important  that  it  be  borne  in  mind  that  the 
sheep  be  folded  for  a  short  time  in  a  place  where  neither  they 
nor  any  other  animal  can  have  a  chance  of  grazing,  or  the  conse- 
quences might  prove  disastrous. 

The  Messrs.  Archibald  state  that  this,  if  applied  about  the 
middle  of  July,  is  not  only  the  best  preventative  but  the  best  cure 
of  the  disease,  provided  always  that  all  loose  and  detached  horn 
is  carefully  removed. 

There  are  a  great  many  so-called  specifics  for  foot-rot ;  if  looked 
into,  however,  they  resolve  themselves  into  caustics  of  various 
kinds.  I  have  found  the  terchloride  of  antimony  (butyr  of  anti- 
mony) as  effectual,  and  much  less  painful  to  the  animal,  than  any 
other  caustic.  If  the  fungoid  growths  be  very  prominent,  it  may  be 
necessary  to  employ  a  strong  acid  ;  in  such  a  case  nitric  acid,  care- 
fully and  sparingly  applied  by  means  of  a  leather  to  the  surface  of 
the  growths,  may  be  used  with  advantage ;  where  there  are  no 
fungoid  growths,  but  merely  a  scalding  between  the  claws,  the 
tincture  of  the  terchloride  of  iron  diluted  with  an  equal  quantity 
of  water  is  a  very  good  application.  In  addition,  I  would  sug- 
gest, that  after  the  feet  are  dressed  with  any  of  the  above-named 
remedies  the  exposed  surfaces  miglit  be  brushed  over  with  a 
quick-drying  varnish,  or  a  solution  of  gutta-percha,  in  order  to 
afford  an  artificial  covering  to  the  inflamed  and  irritable  tissues. 

When  the  fungoid  growths  are  not  very  large,  a  solution  of 
sulphate  of  copper  may  be  used,  and  the  sheep  driven  slowly 
through  it,  or  kept  in  it  Jfor  a  few  minutes. 

If  necrosis  of  the  bones  occurs,  amputation,  if  confined  to  one 
foot,  might  be  resorted  to,  in  order  to  save  a  valuable  ram  or  ewe. 


1 


PLATE  IV 


10 


JixxT^tess  4  CcTnp<atyMdxrC 


TUMOURS. 


EXPLANATION  OF  PHOTO-LITHOGRAPH,  PLATE  IV. 

1.  Malignant  Epulis. — Mouth  of  ox.  The  microscopic  characters 
of  this  tumour  are  given  at  page  419.  The  cells,  as  wiU.  be  seen  by  the 
microscopic  drawing,  Fig.  99,  partake  of  the  nature  of  epithelial  cancer. 

2.  Benign  Epulis. — Mouth  of  sheep.  Microscopically,  the  struc- 
ture of  this  tumour  is  fibrous. 

3.  Epithelioma. — Tongue  of  ox.  The  true  nature  of  the  growths 
are  not  definitely  made  out. 

4.  Medullary  Cancer. — The  tumour  was  originally  roundish  in 
form ;  distinctly  separated  from  surrounding  structures,  and  invested 
in  a  capsule  of  a  semi-fibrous  nature.  The  section  shows  various  de- 
generative changes  which  have  taken  place  within  its  substance.  The 
tumour  was  removed  by  me  from  near  the  stifle-joint  of  a  mare  at 
Berwick-on-Tweed.  It  weighed  four  pounds,  and,  along  with  other 
masses  of  a  similar  character  removed  from  the  mammary  gland  and 
submaxillary  space,  made  up  an  aggregate  mass  weighing  31  lbs.  The 
mare  died  some  time  after  the  operation,  and  a  post  mortem  examina- 
tion revealed  many  other  cancerous  tumours  in  various  internal  organs. 
The  microscopic  characters  of  this  tumour  are  represented  in  woodcuts. 
Figs.  95,  96,  and  97,  page  418. 

5.  Medullary  Cancer  of  the  Tail  (not  melanotic),  showing  the 
arrangement  of  its  several  masses ;  on  the  left  the  tumour  has  ulcer- 
ated.    Kemoved  by  me  from  a  cab-horse ;  no  return  of  the  disease. 

6.  Medullary  Cancer  of  the  Bones  op  the  Face  of  the  Ox. — 
(1.)  Large  tum^'or.  (2.)  Cystic  formation  within  the  superior  maxil- 
lary sinus.     (3.)  (4.)  and  (5.)  Smaller  medullary  tumours. 

7.  Osteo-Sarcoma  of  Ox. — The  specimen  having  been  boiled,  the 
sarcous  matter  is  removed,  the  bony  trabeculse  alone  remaining. 

8.  Cystic  Growth  in  superior  maxillary  sinus  of  a  year-old  colt. 
(1.)  The  cyst.  (2.)  Fifth  and  sixth  molar  teeth  uncut.  (3.)  Fourth 
molar  on  the  point  of  "  cutting."  (4.)  Worm-eaten  fangs  of  tem- 
porary molars  undergoing  absorption. 

9.  Dentigerous  or  Tooth  Tumour,  containing  several  hundred 
rudimentary  teeth,  filling  the  antrum  (2.),  and  extending  from  it  into 
the  cavity  of  the  mouth  (1,  1). 

10.  Large  Nasal  Polypus. — (1.)  The  tumour.     (2.)  Anterior  naris. 


CHAPTER  XXIL 

TUMOURS. 

STRUCTURE  AND  CLASSIFICATION — MALIGNANT  TUMOURS — MICROSCOPIC 
ANATOMY DIVISIONS — SGIRRHUS  OR  HARD  CANCER — SOFT  CAN- 
CERS    COLLOID  MEDULLARY MELANOSIS EPITHELIAL 

CANCER. 

Tumours  are  included  in  that  class  of  diseases  named  hyper- 
trophies or  over-growths ;  and  all  their  varieties  consist  in 
additions  to  the  organized  materials  of  the  body,  arising  from  an 
excess  of  formative  force  ;  but  in  the  case  of  each  kind  of  tumour 
the  mode  is  peculiar  in  which  this  excess  is  manifested.  A 
tumour  differs  from  an  inflammatory  exudate  in — 1st.  That  its 
increase  is  of  itself ;  2d.  That  it  grows  as  a  part  of  the  body  by 
its  own  inherent  force,  depending  on  the  surrounding  parts  for 
little  more  than  a  supply  of  blood,  from  which  it  appropriates 
its  nourishment ;  3d.  As  a  general  rule  a  tumour  increases  con- 
stantly, whereas  an  inflammatory  exudation  depends  upon  a 
morbid  state  of  the  parts  at  or  contiguous  to  it;  and  in- 
creases in  size  only  so  long  as  the  morbid  action  in  the  adjacent 
parts  continues.  Tumours  are  divided  by  Paget  into  innocent, 
malignant,  and  recurrent  or  intermediate  groups.  The  distinction 
between  an  innocent  and  a  malignant  tumour  is  not  one  of  mere 
visible  structure,  nor  of  the  microscopic  character  of  its  cellular 
elements,  but  of  origin  and  vital  properties.  Formerly  it  was 
thought  that  the  cells  of  a  malignant  growth  (cancer  cells)  had 
some  characteristic  peculiarity  by  which  they  could  be  dis- 
tinguished from  those  of  any  other  tumour ;  at  one  time  it  was  a 
"typical  caudate  form;"  then  cancer  cells  were  those  having 
large  eccentric  nuclei ;  or  else  they  were  mother  cells,  containing 
one  or  more  smaller  ones.  At  the  present  time,  however,  the 
question  is  more  the  source  and  origin  of  those  cells  than  any 
peculiarity  in  tlieir  character ;  and  it  is  now  believed  that  their 


MALIGNANT  TUMOURS.  409 

distinctive  characters  are  to  be  sought  in  their  arrangement, 
rather  than  in  the  form  of  the  cells  themselves.  Extended  obser- 
vations have  shown  that  cells  undistinguishable  from  those  of 
cancer  may  be  found  in  certain  sarcomata,  in  glandular  growths, 
and  even  in  healthy  parts,  as  in  the  pelvis  of  the  kidney,  and  the 
prostate  vesicle.     Paget  says — 

"  1st.  The  intimate  structure  of  malignant  tumours  is  usually 
not  like  that  of  any  of  the  fully  developed  natural  parts  of  the 
body,  nor  like  that  which  is  formed  in  a  natural  process  of 
development,  repair,  or  degeneration.  Many  of  the  cells  of 
cancers,  for  example,  may  be  somewhat  like  gland  cells,  or  like 
epithelium  cells,  yet  a  practised  eye  can  distinguish  them  even 
singly.  And  much  more  plainly  their  grouping  distinguishes 
them ;  they  are  heaped  together  disorderly,  and  seldom  have  any 
lobular  or  laminar  arrangement,  such  as  exists  in  the  natural 
glands  and  epithelia,  or  in  the  innocent  glandular  or  epithelial 
or  epidermal  tumours.  These  innocent  tumours  are  really  imi- 
tations, so  far  as  their  structure  is  concerned,  of  the  natural 
parts;  and  the  existence  of  such  imitations  in  any  tumours 
makes  the  diversity — the  heterology,  as  it  is  called — of  the 
malignant  tumours  appears  more  evident.  Still  this  rule  of 
dissimilarity  of  structure  in  malignant  tumours  is  only  general. 
The  other  properties  of  malignancy  may  be  sometimes  observed 
in  tumours  that  have  apparently  the  same  structure  as  those 
that  are  generally  innocent.     .     .     . 

"  2d.  Malignant  growths  may  have  the  character  of  infiltra- 
tions, i.e.,  their  elementary  structures  may  be  inserted,  infil- 
trated, or  diffused  in  the  interspaces  and  cavities  of  the  tissues 
in  which  they  lie.  Thus,  in  its  early  stage,  a  malignant  tumour 
may  comprise,  with  its  own  proper  elements,  those  of  the  organ 
in  which  it  is  formed ;  and  it  is  only  in  its  later  life  that  the 
elements  of  the  tissue  or  organ  disappear  from  it,  gradually  de- 
generating and  being  absorbed,  or  possibly  yielding  themselves 
as  materials  for  its  growth. 

"  Thus  a  hard  cancer  of  the  mammary  gland  includes  in  its 
mass  a  part,  or  even  the  whole,  of  the  gland  itself,  as  if  there 
were  only  a  conversion  of  the  gland  tissue ;  and  one  may  find 
within  the  very  substance  of  the  cancer  the  remains  of  the  lacti- 
ferous tubes  involved  in  it,  and  with  the  microscope  may  trace  in 
it  the  connective  tissue  that  separated  the  gland -lobes^  and  the 


410  TUMOURS. 

degenerate  elements  of  the  epithelial  contents  of  the  tubes  and 
acini.  But  among  all  these  lie  the  proper  cells  of  the  cancerous 
growth,  and  these  usually  increase  while  the  original  structures 
of  the  gland  decrease.  So,  too,  in  medullary  cancerous  disease  of 
the  uterus,  the  uterus  itself,  or  part  of  it,  is  in  the  tumour  and 
gradually  disappears,  while  the  medullary  matter  diffused  or  in- 
filtrated in  it  is  growing. 

"  The  malignant  growths  may,  I  say,  thus  appear  as  infiltra- 
tions ;  but  they  are  not  always  so.  Thus,  though  the  hard  cancer 
of  the  breast  is,  commonly  or  always,  an  infiltration  of  cancerous 
substance  in  and  among  the  proper  structures  of  the  gland,  yet 
the  hard  cancer  of  the  bones  is  often  a  distinct  tumour,  such  as 
has  no  mixture  of  bone  in  it,  and  may  be  enucleated  from  the 
cavity  or  shell  of  bone  in  which  it  lies.  So,  too,  while  the 
medullary  cancer  of  the  uterus  plainly  consists  in  an  infiltration 
or  insertion  of  new  material  in  the  substance  of  the  organ,  that 
of  the  breast  is  usually  a  separate  tumour,  and  altogether  dis- 
continuous from  the  surrounding  parts. 

"  Many  other  instances  of  similar  contrast  might  be  cited ; 
still  the  fact  that  their  elementary  structures  may  be  thus  infil- 
trated in  the  tissues  they  affect  is  a  characteristic  feature  of 
malignant  tumours.  I  think  it  is  rarely  imitated  in  cases  of  in- 
nocent tumours. 

"  od.  It  is  also  generally  characteristic  of  malignant  tumours 
that  they  have  a  peculiar  tendency  to  ulcerate,  their  ulceration 
being  preceded  by  softening.  One  can,  indeed,  in  this  particu- 
lar, only  observe  a  graduated  difference  between  the  innocent  and 
malignant  diseases ;  for  certain  innocent  tumours,  if  they  grow 
very  rapidly,  are  apt  very  rapidly  to  decay ;  and  they  may  sup- 
purate and  discharge  their  ichor  and  debris  with  foul  and 
dangerous  ulceration.  Thus  the  quickly  growing  cartilaginous 
tumours  may  imitate  in  these  respects  the  malignant  growths ; 
so  may  large  fibrous  tumours  when  they  soften  and  decay.  Or 
again,  when  an  innocent  tumour  grows  more  rapidly  than  the 
parts  over  it  can  yield,  they  may  waste  and  ulcerate,  and  allow 
it  to  protrude ;  and  it  may  now  itself  ulcerate  and  look  very 
like  malignant  disease.  This  may  be  seen  in  the  protruding 
fibrous  tumours  that  ulcerate  and  bleed ;  or,  in  a  more  striking 
manner,  in  the  protruding  vascular  growths  that  have  sprung 
up  in  the  cystic  tumours  of  the  breast.     Or,  once  more,  the 


MALIGNANT  TUMOURS.  411 

characters  of  readiness  to  -ulcerate  may  be  imitated  by  innocent 
tumours  after  injuries,  or  in  exposure  to  continued  irritation ;  for 
they  resist  these  things  with  less  force  than  the  similar  natural 
parts  do.  Hence  sloughing  and  ulcerating  fibrous,  erectile,  and 
other  tumours,  have  been  often  thought  cancerous,  and  so  de- 
scribed. The  respective  tendencies  to  ulcerate  can  therefore  be 
counted  only  as  constituting  differences  of  degree  between  the 
innocent  and  malignant  tumours.  We  may  speak  of  a  liability 
in  one  case,  of  a  proneness  in  the  other. 

"  4ith.  The  softening  that  often  precedes  the  ulceration  of 
malignant  growths  can  hardly  be  considered  separately  from  the 
minute  account  of  their  structure.  I  therefore  pass  by  it,  and 
proceed  to  the  fourth  distinctive  character,  which  is  to  be  noticed 
in  the  modes  of  their  ulceration. 

"  This  is,  that  the  ulcer  which  forms  in  or  succeeds  a  malig- 
nant growth  has  no  apparent  disposition  to  heal ;  but  a  morbid 
substance,  like  that  of  which  the  original  growth  was  composed, 
forms  the  walls  or  boundaries  of  the  ulcer ;  and  as  this  substance 
passes  through  the  same  process  of  ulceration  which  the  primary 
growth  passed  through,  so  the  malignant  ulcer  spreads  and  makes 
its  way  through  tissues  of  all  kinds. 

"  In  contrast  with  this  character  of  malignant  growths,  it  is 
observable  that  beneath  and  around  an  ordinary  ulcer  of  the 
natural  tissues,  or  of  an  innocent  tumour,  we  find  the  proper 
tissues  unchanged;  or  perhaps  infiltrated  and  succulent  with 
recent  lymph,  or  the  materials  for  repair;  or  somewhat  indu- 
rated with  lymph  already  organized.  The  base  and  margins 
of  a  cancerous  ulcer  are  themselves  also  cancerous ;  those  of  a 
common  ulcer  are  infiltrated  with  only  reparative  or  inflamma- 
tory material.  In  like  manner,  if  ulceration  extend  through 
an  innocent  growth,  it  may  destroy  it  all,  and  no  similar  growth, 
will  form  in  the  adjacent  parts,  replacing  that  which  has  been 
destroyed ;  but  in  the  ulceration  of  cancer,  while  the  cancerous 
matter  is  being  constantly  discharged  by  sloughing  or  ulcera- 
tion from  the  surface,  new  matter  of  the  same  kind,  and  in  more 
abundance,  is  being  formed  at  some  distance  from  the  surface ; 
so  that  in  a  section  through  an  ulcerated  cancer,  one  does  not 
arrive  at  healthy  tissues  till  after  passing  through  a  stratum  of 
cancer. 

"  5^A.    Malignant  tumours  are  again  characterised   by  this, 


412  TUMOURS. 

that  they  not  only  enlarge  but  apparently  multiply  or  propagate 
themselves ;  so  that,  after  one  has  existed  for  some  time,  or  has 
been  extirpated,  others  like  it  grow,  either  in  widening  circles 
around  its  seat,  or  in  parts  more  remote. 

"  Mere  multiplicity  is  not  a  distinctive  character  of  malig- 
nant diseases,  for  many  innocent  tumours  may  be  found  in  the 
same  person.  But  in  the  conditions  and  circumstances  of  the 
multiplicity  there  are  characteristic  differences.  Thus,  when 
many  innocent  tumours  exist  in  the  same  person,  they  are 
commonly,  or  always,  all  in  one  tissue.  A  man  may  have  a 
liundred  fatty  tumours,  but  they  shall  all  be  in  his  subcu- 
taneous fat.  Many  fibrous  tumours  may  exist  in  the  same 
uterus,  but  it  is  so  rare,  that  we  may  call  it  chance,  if  one  be 
found  in  any  other  part  in  the  same  patient ;  so  many  cartila- 
ginous tumours  may  be  in  the  bones  of  the  hands  and  feet, 
but  to  these,  or  to  these  and  the  adjacent  bones,  they  are 
limited. 

"  There  is  no  such  limitation  in  the  cases  of  multiplicity  of 
malignant  tumours.  They  tend  especially  to  affect  the  lym- 
phatics connected  with  the  part  in  which  they  first  arise ;  but 
they  are  not  limited  to  these.  The  breast,  the  lymphatics,  the 
skin  and  muscles,  the  liver,  the  lungs  may  be  all,  and  at  once, 
the  seats  of  tumours.  Indeed  (and  here  is  the  chief  contrast), 
it  is  more  common  to  find  the  many  malignant  tumours  scat- 
tered through  several  organs  or  tissues  than  to  find  them  limited 
to  one. 

"  Moreover,  if  there  be  a  multiplicity  of  innocent  tumours, 
they  have  generally  a  contemporary  origin,  and  all  seem  to  make 
(at  least  for  a  time)  a  commensurate  progress.  But  the  more 
ordinary  course  of  malignant  tumours  is,  that  one  first  appears, 
and  then,  after  a  clear  interval  of  progress  in  it,  others  appear ; 
and  these  are  followed  by  others,  which,  with  an  accelerating 
succession,  spring  up  in  different  parts. 

"  Qth.  A  sixth  distinctive  character  of  malignant  tumours  is 
that  in  their  multiplication,  as  well  as  in  their  progress  of 
ulceration,  there  is  scarcely  a  tissue  or  an  organ  which  they  may 
not  invade.     .     .     . 

"  Such  are  the  general  characters  of  malignant  tumours. 
Those  of  innocent  ones  are  their  opposite  or  negatives.  Thus 
innocent  tumours  have  not  a  structure  widely  different  from  that 


MALIGNANT  TUMOURS.  '  413 

of  a  natural  tissue ;  they  do  not  appear  as  infiltrations  displacing 
or  overwlielming  the  original  tissues  of  their  seat ;  they  do  not 
show  a  natural  proneness  to  ulceration;  nor  is  the  ulceration 
which  may  happen  in  one  through  injury  or  disease  prone  to 
extend  into  adjacent  parts ;  they  do  not  grow  at  the  same  time 
in  many  different  tissues. 

"  Of  recurrent  tumours ;  the  chief  destructive  characters  are, 
that,  like  innocent  tumours,  their  structures  resemble  those  of 
the  natural  tissues,  but  only  in  a  rudimental  state,  or  in  con- 
ditions that  may  be  likened  to  malformations;  that  they  do 
not  appear  as  infiltrations ;  that  their  ulceration,  to  which,  how- 
ever, they  are  more  prone  than  most  innocent  tumours,  is  not 
apt  to  extend  into  adjacent  parts;  but  that,  like  malignant 
tumours,  they  do  sometimes  appear  in  organs  distant  from 
their  first  seat,  and  are  exceedingly  prone  to  be  repeatedly  re- 
formed after  complete  extirpation." — (Paget's  Lectures  on  Sur- 
gical Pathology) 

I  have  made  the  foregoing  extensive  quotation  from  Paget, 
as  it  clears  up,  in  a  most  masterly  manner,  the  great  confusion 
prevailing  amongst  veterinarians  upon  the  nature  of  the  limited 
variety  of  tumours  which  are  seen  in  veterinary  practice,  and  it 
also  shows  how  rare  an  affection  cancer  is  in  the  domesticated 
animals.  Numerous  cases  are  recorded  in  the  Veterinarian; 
but,  to  my  mind,  the  proof  that  many  of  them  were  really 
cancerous  is  quite  insufficient.  At  the  same  time,  it  cannot 
be  said  that  the  horse  is  not  subject  to  cancer,  although  some 
veterinarians  believe  such  to  be  the  case.  After  examining  the 
various  reports  upon  cancer,  in  the  Veterinarian  and  Edinhurgh 
Veterinary  Review,  I  am  of  opinion  that  the  following  cases  were 
those  of  malignant  disease,  namely:-^ 

1st.  Hard  cancer  in  vagina  and  mammary  glands  of  a  mare, 
reported  in  the  Clinique  of  the  Veterinary  School  of  Lyons. — 
Veterinarian,  1839. 

2d,  Hard  cancer  in  submaxillary,  mesenteric,  inguinal,  and 
other  glands,  reported  by  Mr.  A.  Cherry,  London. —  Veterinarian, 
1855. 

M.  Epithelial  cancer  of  the  bladder  of  a  horse,  reported  by 
Messrs.  C.  andD.  Shorten,  Ipswich. —  Veterinarian,  1855. 

Uh.  A  case  of  scirrhus  of  the  stomach,  reported  by  Mr.  E. 
Coleman,  Sutton. —  Veterinarian,  1857. 


414  TUMOUES. 

^tli.  Epitlielial  cancer  of  nose  and  "bones  of  the  face,  reported 
by  Kopp. — Udinhurgh  Veterinary  Reviciu,  1859-60. 

These  examples  could  easily  be  multiplied,  but  I  will  only 
add  that  colloid  cancer  of  the  duodenum  of  the  horse  has  been 
observed  by  my  colleague.  Dr.  Young.  In  my  own  practice  the 
following  instances  (in  addition  to  those  represented  in  the  photo- 
lithograph  facing  this  chapter)  have  been  observed : — 1st.  ]\Iedul- 
lary  cancers  in  the  scrotum  (two  instances  in  geldings) ;  2d. 
Scirrhus  of  the  penis  ;  '6d.  Large  medullary  cancer  in  the  seat 
of  an  old  wound  on  the  thoracic  walls  of  an  aged  half-bred 
Arab  mare ;  4dh.  Scirrhus  of  the  mammary  glands  in  dogs  and 
bitches;  K>t]i.  Melanotic  cancers,  some  of  them  isolated  tumours; 
others  extensive  infiltrations,  weighing  as  much  as  sixteen  pounds 
in  one  instance,  in  the  tail,  pelvic,  inguinal,  brachial,  bronchial, 
and  mesenteric  glands,  spinal  cord,  and  other  organs  of  grey 
horses ;  and  Qth.  Colloid  cancer  of  ovaries  and  kidneys. 

The  origin  of  cancer  has  been  profoundly  studied  by  patho- 
logists, but  there  is  still  much  difference  of  opinion.  Some  view 
it  as  performing  the  function  of  a  new  excretory  organ,  or  a 
growth  arising  for  the  purpose  of  eliminating  from  the  S3"stem 
an  unhealthy  matter  which  is  generated  within  it.  Others 
believe  that  it  originates  from  wandering  white  corpuscles  or 
leucocytes ;  these  as  it  were  furnishing  the  starting-points  for  the 
cells  of  cancer,  as  of  many  other  new"  growths ;  whilst  otlier 
observers  of  great  eminence  maintain  that  the  cells  of  schirrus 
originate  in  the  epithelial  cells  of  a  gland ;  and  others  again, 
equally  eminent,  are  of  opinion  that  they  are  developed  from  the 
connective-tissue  cells.  Dr.  Handfield  Jones  says  that  "we 
should  recognise  in  cancer  a  grave  alteration  of  the  normal 
formative  powers — those  real  but  occult  influences  which  deter- 
mine that  here  bone,  and  there  muscle,  and  there  nerve,  shall  be 
produced." 

Tlie  accompanying  woodcuts  of  cancer  cells  in  their  various 
stages  exl libit  to  a  remarkable  degree  their  form  and  metamor- 
phosis, as  observed  by  Dr  Young  and  myself  in  our  microscopic 
examinations  of  cancer  tumours : — 


MICROSCOPIC  ANATOMY  OF  CANCER. 


415 


MICROSCOPIC  ANATOMY  OF  CANCER. 

Tig.  83. 

m 


if  xllSr 


Fig.  80.  Fig.  81.  Fig.  82. 

Fig.  80. — CoUoid  cancer.     Appearance  of  the  fibrous  areolae  filled  with  cancer 
cells. 

Fig.  81. — Fibrous  stroma,  deprived  of  the  cells  by  pressure  and  washing. 
Fig.  82. — Stroma  and  cells,  after  the  addition  of  acetic  acid. 
Fig.  83. — Some  of  the  cells  isolated.     250  diam. — (Bennett.) 


Fig.  84.  Fig.  85. 

Fig.  8  4.  — Colloid  tissue,  with  the  loculi  filled  with  molecular  matter,  in  which 
cells  are  commencing  to  form.  On  the  left  of  the  figure  one  of  the  molecular 
masses  has  been  squeezed  out  of  the  fibrous  matrix  ;  below  are  masses  of  mineral 
matter,     250  diam. — (Bennett.) 

Fig.  85. — Alveolar  stroma  of  cancer,  obtained  by  pencilling  out,  under  water,  a 
very  thin  section  of  a  scirrhous  tumour  of  the  breast.     220  diam. — (Arnott.) 


416 


TUMOURS. 


Fig.  88. 


Fig.  87. 


Fig.  86. 


vSO-'.o  ■«■ 


Fig.  89. 


Fig.  90. 


Fig.  91. 


Fig,  86. — Typical  mature  carcinoma  from  a  scirrhous  breast.  Probably  by  the 
action  of  the  chromic  acid  solution  employed  to  harden  the  specimen,  the  cells  have 
shrunk  away  from  the  alveolar  walls  to  some  extent.     220  diam. — (Arnott.) 

Fig.  87. — Young  cancer  cells  from  testicle. 

Fig.  88. — The  same,  after  addition  of  acetic  acid. 

Fig.  89. — Older  cells,  from  a  tumour  in  duodenum. 

Fig.  90. — The  same,  after  addition  of  acetic  acid. 

Fig.  91. — Highest  development  of  cancer  ceUs,  including  secondary  cells,  from 
a  tumour  of  the  toe.     250  diam. — (Bennett.  ) 


FiO.  92. — Various  cells,  from  a  carcinomatous  tumour.     220  diam. — (Arnott.) 


MICROSCOPIC  ANATOMY    OF  CANCER. 


417 


Fig.  93. 

Fig.  93. — Diagram  representing  the  several  stages  of  carcinoma,  a.  Granular 
corpuscles  collected  into  groups  (connective -tissue  proliferation  ?).  6.  Young  oval 
nucleated  cells  clustered  together,  c.  Typical  mature  structure,  d.  Gradual 
withering  by  fatty  degeneration  of  cell  elements  and  shrinking  of  the  alveoli — 
(Arnott.) 


^ 


T^i'i::^' 


isfj^ 


Fig.  94. 

Fio.  94. — Simple  and  compound  cancer  cells  from  duodeniun.     Several  contain 
fluid  by  endosmose,  which  strongly  refracts  light.     250  diam. — (Bennett.) 


2e 


418  ■  TUMOUES. 

MICROSCOPIC  ANATOMY  OF  CANCER  IN  HORSE  AND  OX. 


Fig.  95 


Xi20 


Fig.  98. 


Fig.  97. 

Fig.  9.5.— Medullary  sarcoma  of  horse  (specimen  obtained  from  Plate  IV., 
Fig.  4),  showing  groups  of  cancer  cells  imbedded  in  fibrous  stroma.     200  diam. 

Fig.  96. — Portion  of  same  tumour  magnified  300  diam. 

Fig.  97.— a.  b.  c.  d.  e.  f.  cj.  Detached  cells,  and  fibrous  stroma  with  empty  loculi, 
from  same  tumour.     420  diam. 

Fig.  98. — Melanotic  cancer  from  tail  of  a  grey  horse,  showing  pigment  matter 
enclosed  in  cells,  and  lying  free  in  fibrous  stroma,     420  diam. 


MICROSCOPIC  ANATOMY  OF  CANCER. 


419 


Fig.    99. — Section  of  epithelial  cancer  from  palate  of  the  ox,  showing  large 
flattened  cells,  with  numerous  smaller  ones  enclosed  in  a  fibrous  matrix.     250  diam. 

Cancer  in  the  domesticated  animals  may  be  classified  as  hard, 
soft,  epitlielial,  and  black. 


HARD  CANCER,  OR  SCIRRHUS, 

Is  dense  and  white  in  its  structure,  arranged  in  masses,  with 
projections  passing  from  its  centre  to  various  parts  of  the  organ 
which  it  attacks.  It  cuts  up  almost  like  cartilage,  and  after 
being  cut  the  surfaces  both  become  concave,  and  the  haemorr- 
hage from  them  is  uniform,  without  jet,  and  more  excessive 
than  from  the  surrounding  tissues.  It  differs  from  a  simple 
tumour  by  being  more  rapid  in,  its  growth,  by  its  tendency  to 
involve  the  lymphatic  glands,  to  break  through  the  organ  in 
which  it  is  developed,  and  to  involve  neighbouring  textures. 
When  developed  in  the  mouth  and  face,  it  interferes  with  the 
process  of  mastication,  and  causes  the  animal  rapidly  to  lose 
flesh ;  but  when  it  is  so  situated  as  not  to  interfere  with  any  of 
the  animal  or  vital  functions,  it  does  not  seem  to  affect  the 
constitution  for  a  long  period,  or  until  ulceration  has  taken  place. 
The  ulcer  then  involves  the  adjacent  parts,  and  a  fungus  is 
thrown  out,  haemorrhage  occurs,  and  the  patient  suffers  from 
irritation  and  exhaustion. 


420  TUMOURS. 

The  only  treatment  is  early  removal,  if  the  tumour  is  situated 
in  a  part  where  an  operation  can  be  performed.  The  applica- 
tion of  escharotics  is  not  to  be  recommended,  excision  being  by 
far  the  better  method.  In  the  mamm?e  of  dogs  the  operation 
nearly  always  affords  relief,  if  the  brachial  or  inguinal  glands 
be  not  affected.  I  have  operated  on  many  cases,  and  always 
with  success ;  but  I  have  taken  care  not  to  do  so  when  the 
glands  are  much  enlarged ;  but  if  the  external  gland  be  enlarged, 
and  when  it  can  be  ascertained  that  internal  ones  are  not  in- 
volved, the  former  as  well  as  the  original  tumour  are  to  be  excised. 

Professor  Bennett  has  suggested  a  method  of  destroying  can- 
cer, by  injecting  weak  acetic  acid  into  the  tumour.  The  sug- 
gestion has  arisen  from  the  fact  that  acetic  acid  destroys  the 
cells  of  cancer,  transforming  them  into  amorphous  matter. 

SOFT  CANCER. 

This  is  met  with  in  two  forms,  namely,  medullary  sarcoma 
or  cerebriform  tumour,  and  the  colloid,  alveolar,  or  gelatini- 
form,  as  it  is  variously  named.  The  term  colloid  seems  to  be 
preferred  by  modern  writers. 

(1.)  Colloid  Cancer. — I  have  met  with  specimens  of  colloid 
cancer,  since  the  publication  of  the  first  edition  of  this  work,  in 
the  ovaries,  kidneys,  and  in  the  brachial  lymphatics.  The 
specimens,  as  well  as  one  met  with  in  the  duodenum  of  the 
horse  by  Dr.  Young,  were  found  to  correspond  with  those  seen 
in  human  beings,  in  whom  it  is  found  as  a  primary  disease, 
principally  in  the  digestive  organs,  uterus,  mammary  gland,  and 
peritoneum  :  and,  as  a  secondary  disease,  in  the  lungs  and 
lymphatic  giands.  It  consists  of  fibres  so  arranged  as  to  form 
alveoli  or  spaces,  varying  in  size,  and  containing  a  soft,  viscous, 
and  nearly  liquid  matter,  grey  or  amber-like  in  colour,  but 
sometimes  opaque,  and  of  a  greenish -yellow^  hue.  This  is  the 
true  colloid,  or  glue-like  substance.  The  density  of  the  tumour 
mil  depend  upon  the  proportions  of  its  two  constituent 
materials.  If  the  colloid  matter  predominates  over  the  fibrous 
material,  the  tumour  will  have  a  soft,  fluctuating  feel,  and  will 
be  made  up  of  large  masses  of  colloid  substance,  intersected  by 
white  fibrous  cords  or  thin  partitions,  arranged  as  in  areolar 
tissue.  But  when  the  fibrous  texture  is  predominant,  the 
tumour  will  appear  as  a  tough,  white,  fascia-like  mass,  con- 


i 


SOFT  CANCER.  421 

taining  small  separate  cavities  or  cysts  filled  with  the  colloid 
substance. 

(2.)  Medullary  Cancer  is  developed  in  the  form  of  circum- 
scribed tumours  or  infiltrations.  The  case  from  which  the 
specimen  seen  in  Photo-lithograph,  Plate  IV.,  Fig.  4,  was  taken, 
presented  both  varieties,  the  circumscribed,  as  well  as  the  in- 
filtrated form,  in  the  mammary  region ;  infiltrations  only  in  the 
submaxillary  space,  and  one  w^ell-defined  circumscribed  tumour 
(that  represented  in  the  figure),  weighing  four  pounds,  upon  the 
outer  side  of  the  thigh. 

Many  names  have  been  given  to  this  variety  of  cancer,  such 
as  fungus-hsematodes,  cephaloma,  encephaloma,  encephaloid,  car- 
cinoma medullare,  medullary  fungus,  medullary  sarcoma,  &c.  It 
is  found  in  the  glands,  in  the  inter-muscular  structures,  in  the 
penis,  scrotum,  the  orbit,  submaxillary  space,  and  in  the  bones 
and  periosteum. — (See  Photo-lithograph,  Plate  IV.,  Fig.  6.) 

Medullary  cancer  may  present  itself  as  one  tumour ;  but  when 
cut  into,  it  will  be  found,  as  a  rule,  to  be  made  up  of  several 
smaller  ones,  enclosed  in  a  distinct  wall  or  boundary;  or  its 
multiple  character  may  be  defined  by  external  examination.  To 
the  touch  it  presents  a  peculiar  soft  elastic  feel  of  the  slow  fluc- 
tuation of  some  thick  liquid,  w^hich  may  be  mistaken  for  pus  or 
serum  by  an  inexperienced  examiner.  The  veins  over  the  tumour 
are  congested  ;  the  skin  retains  its  natural  appearance  for  a  long 
time;  but  eventually  becomes  tense  and  painful,  the  pain 
being  referable  to  the  tension  of  the  nerves  and  surrounding 
tissues — the  tumour  itself  not  being  sensitive — and  then 
ulcerates  and  bleeds.  Ulceration  does  not  take  place  very 
readily;  but  when  it  occurs,  a  fungous  growth  soon  appears, 
and  much  of  the  brain-like  matter  of  which  the  tumour  is 
composed,  along  with  much  blood,  is  discharged.  A  separable 
medullary  cancer  may,  as  a  whole,  present  a  very  irregular  sur- 
face, having  a  tendency  to  extend  in  the  direction  of  the  inter- 
muscular spaces,  as  in  one  case  where  I  found  it  in  the  walls  of 
the  abdomen.  In  this  instance  the  tumour  was  almost  of  a 
triangular  shape,  with  its  base  turned  backwards,  extending  for 
about  fourteen  inches  under  the  panniculus  carnosus,  and 
adapting  itself  to  the  form  of  the  spaces  existing  between  the 
pectoralis  magnus  and  serratus  magnus  muscles.  But  though 
the  mass  may  be  irregular  in  the  aggregate,  its  component  lobes 
are  round  or  oval,  and  readily  adapt  themselves  to  surrounding 


422  TUMOURS.^ 

parts.  They  grow  deeply  in  loose  areolar  spaces,  but  their 
boundaries  are  more  superficial  where  the  surrounding  struc- 
tures are  firm.  The  parts  around  the  lobes  are  not  usually 
infiltrated,  as  each  lobe  is  surrounded  by  a  more  or  less  distinct 
capsule,  which  seems  not  only  to  enclose  each  individual  lobe, 
but  to  extend  over  and  involve  the  whole  tumour.  This  is 
easily  separated  from  the  surrounding  structures,  and  when  cut 
into  allows  its  contents  to  protrude,  or,  when  very  soft,  to  ooze 
out.  The  blood-vessels,  which  are  numerous  in  the  capsule,  are 
tortuous  in  their  course,  peculiarly  friable  in  their  texture,  and 
usually  surrounded  by  the  medullary  matter.  This  friability  of 
the  vessels  renders  it  very  difficult  to  apply  ligatures,  as  the  pres- 
sure required  to  arrest  the  haemorrhage  usually  breaks  through 
the  easily  lacerable  vessels. 

When  cut  into,  the  lobes  are  seen  to  be  composed  of  a  peculiar 
soft  substance  (the  medullary  matter),  which  is  easily  broken 
and  spread  out  with  the  fingers.  It  resembles  reddish-coloured 
brain  matter,  and  is  sometimes  softer  than  brain.  I  have  never 
seen  it  white,  as  described  by  human  pathologists  ;  but  the  tint 
is  usually  clear,  that  is  to  say,  there  is  no  purulent  or  fibrinous 
opacity.  Masses  of  a  peculiar  looking  substance  are  seen  in  it. 
These  are  yellowish,  rounded  bodies,  similar  to  very  small  cysts, 
and  in  mass  resembling  Indian  meal  or  coarse  porridge.  This 
matter  is  often  found  between  the  lobes,  as  well  as  within  them. 
In  their  centres  the  contents  of  the  lobes  are  seen  to  be  under- 
going fatty  degeneration. 

When  the  cancer  is  pressed  or  scraped,  it  yields  a  turbid 
material,  '^  cancer  juice,"  and  leaves  a  small  quantity  of  fibrous 
tissue,  with  numerous  blood-vessels.  This,  as  well  as  the  cancer 
juice,  is  formed  during  the  growth  of  the  cancer,  and  therefore 
differs  from  the  "  stroma  of  scirrhus  "  by  being  part  of  the  malig- 
nant growth,  and  not  of  the  tissue  in  which  it  grows. 

It  was  supposed  at  one  time  that  the  vascular  system  of  these 
cancers  was  either  exclusively  venous  or  arterial ;  but  it  is  now 
proved,  by  the  experiments  of  Lebert  and  others,  that  they 
contain  arteries,  capillaries,  and  veins,  arranged  in  net-works  of 
varying  closeness ;  and  it  is  also  probable  that  the  difficulty  of 
injecting  veins  in  some  of  them  is  due  to  their  being  filled  with 
cancerous  matters,  which  stops  the  injection,  after  it  has  tra- 
versed the  capillaries.  The  vessels  are  very  abundant,  and  are 
not  only  friable  in  structure,  but  defective  in  muscular  tonicity. 


SOFT  CANCER.  423 

hence  their  liability  to  bleed  when  the  tumour  ulcerates,  or 
when  wounded  accidentally ;  and  it  is  due  to  this  that  the  name 
fungus-hsematodes  has  been  applied. 

Medullary  cancer  may  arise  from  an  accidental  injury,  such 
as  a  blow  or  wound.  In  the  case  of  cancer  of  the  side  of  thorax 
and  abdomen  (page  414),  the  tumour  arose  in  the  cicatrix  of  an 
old  wound ;  the  tumour  had  been  present  for  several  years,  and 
gradually  increased  in  size,  until  it  became  unsightly,  and  inter- 
fered with  the  application  of  the  saddle-girths. 

EPITHELIAL  CANCER. 

Epithelial  cancerous  tumours,  also  known  as  epithelioma 
or  cancroid,  consist  of  a  fibrous  stroma,  in  which  papillse  and 
epithelium  are  found  greatly  multiplied  and  enlarged.  The  cells, 
when  microscopically  examined,  are  found  to  be  numerous,  flat, 
round,  oval,  or  elongated,  containing  a  simple  nucleus ;  and  other 
cells  containing  large  nuclei,  which  appear  as  if  in  process  of 
development  into  cells.  They  differ  but  little  from  the  natural 
epithelial  cells  of  the  part ;  and  as  the  minute  structure  of  this 
form  deviates  least  of  all  the  cancers  from  the  natural  structures 
upon  which  it  grows,  so  its  course  and  history  exhibit  but  little 
malignancy. 

Its  chief  site  is  the  skin  and  mucous  membranes,  but  particu- 
larly at  the  junction  of  the  two ;  as  the  mouth  of  mucous  orifices, 
the  vulva,  anus,  eyelids,  and  edges  of  the  mouth.  It  is  a  very 
rare  form  in  the  lower  animals ;  arises  from  some  previous  local 
disease  or  injury ;  and  is  seen  more  frequently  in  dogs  than  in 
the  other  domesticated  animals. — (Fig.  99.) 

MELANOSIS,  OR  BLACK  SARCOMA. 

Melanosis,  described  in  the  last  edition  of  this  work  as  Black 
Cancer,  is  found,  upon  further  investigation,  to  belong  to  that 
class  of  tumours  now  known  as  the  sarcomata,  or  tumours  con- 
sisting of  embryonic  connective  tissue,  of  which  several  forms 
are  described,  namely,  fibro-plastic,  fibro-nucleated,  recurrent- 
fibroid,  and  myeloid  tumours. — (See  Paget,  Green,  &c.) 

In  structure  the  sarcoma  consists  of  connective  tissue,  which 
retains  its  embryonic  characters  and  cells,  which  constitute  nearly 
the  whole  of  the  growth,  presenting  three  principal  varieties — the 
round,  the  fusiform,  and  the  myeloid  cells.  The  round  cells  are 
those  generally  found  in  the  melanosis  of  the  lower  animals,  and 


424  TUMOURS. 

are  similar  in  form  to  white  blood  corpuscles,  but  containing 
granules  of  dark  pigmentary  matter,  which  give  the  tumours 
their  characteristic  black  appearance. 

The  dark  granules  of  pigment  not  only  fill  the  cells,  but  lie 
free  in  the  surrounding  fibres,  as  shown  in  Fig.  98. 

Melanosis  has  hitherto  been  described  as  a  benign  disease  in 
the  lower  animals,  both  by  human  and  veterinary  pathologists. 
Professor  Spence  says — "  The  melanotic  cancer  has  this  pecu- 
liarity, that  a  form  of  it  occurs  in  the  lower  animals  which  cannot 
be  distinguished  from  the  black  cancer  in  man.  But  in  the 
former  case  it  is  not  malignant,  and  has  no  tendency  to  return 
after  removal,  while  in  the  human  subject  it  is  plainly  and 
entirely  a  malignant  disease — a  melanotic  form  of  cerebriform 
cancer."  Paget  says — "  In  the  horse  and  dog,  I  believe,  black 
tumours  occur  which  have  no  cancerous  character;  but  none 
such  are  recorded  in  human  pathology." 

I  have  seen  a  great  many  cases  of  melanosis,  but  I  never  saw 
one  in  the  horse,  the  history  of  which  I  could  afterwards  trace, 
where  the  disease  did  not  return  ;  and  if  recurrence  only  were 
the  special  characteristic  of  malignancy,  this  would  prove  the 
true  nature  of  the  growth,  without  a  shadow  of  doubt.  But  a 
malignant  is  not  the  only  growth  that  is  liable  to  recur,  hence 
the  recurrent  character  of  melanosis  can  only  be  taken  as  one 
fact  to  prove  its  malignity. 

I  have  also  seen  melanosis  in  horned  cattle  of  various  colours, 
but  more  particularly  in  those  of  a  dark  brown  or  black  colour, 
and  as  a  rule  early  removal  has  been  effectual,  and  there  has 
been  no  recurrence. 

A  melanotic  tumour  has  all  the  specialities  of  malignancy.  Ist. 
Its  minute  structure  is  not  like  any  of  the  fully-developed  natural 
parts  of  the  body.  2d.  It  is  usually  an  infiltration;  and  this 
characteristic  is  much  more  manifest  than  in  medullary  cancer ; 
although  it  may  appear  as  separable  masses,  it  will  be  found, 
on  close  examination,  that  the  structures  surrounding  the  tumour 
are  deeply  tinged  with  the  pigmentary  matter,  and  that  they 
gradually  disappear  either  by  absorption  or  by  being  appropriated 
as  materials  for  the  growth  of  the  malignant  disease.  3d.  It 
has  a  tendency  to  enlarge,  not  only  by  growth,  but  apparently 
by  multiplying  itself  in  the  formation  of  other  tumours  around 
it,  or  in  more  remote  parts  of  the  body.  4:th.  Ulceration  in 
melanosis  is  as  constant  as  in  the  other   malignant   tumours. 


MELANOSIS.  425 

And,  lastly,  there  is  scarcely  a  tissue  or  an  organ  that  melanosis 
may  not  invade.  It  may,  therefore,  be  safely  concluded  that 
"  melanotic  or  melanoid  tumours  are,  with  very  rare  exceptions, 
sarcomatous  tumours,  modified  by  the  formation  of  black  pig- 
ment in  their  elemental  structures."  It  may  also  be  mentioned 
that  melanotic  tumours  in  the  human  being  have  their  favourite 
seats  in  or  beneath  pigmentary  moles. 

Melanosis  is,  with  very  rare  exceptions,  confined  to  grey  horses, 
and  becomes  developed  as  they  whiten  with  age.  Its  favourite 
seat  is  on  the  under  surface  of  the  tail,  around  the  anus  or  vagina, 
or  the  perinaeum ;  more  rarely  the  scrotum,  mammary  gland,  inner 
surface  of  thigh,  and  on  the  nose  or  lips.  These  are  merely  its 
outward  manifestations ;  for  on  dissection  it  may  be  found,  either 
in  large  masses  or  as  small  multiple  tumours,  in  the  mesenteric, 
bronchial,  deep  inguinal,  and  lumbar  glands,  and  in  the  spinal 
canal.  I  do  not  think  that  there  is  any  part  of  the  body  that  may 
not  be  affected  by  these  tumours ;  but  I  wish  to  confine  myself 
strictly  to  those  cases  that  have  fallen  under  my  own  notice. 

In  some  cases  there  are  no  external  tumours.  The  dissection 
of  one  case — death  occurring  from  dropsy — revealed  a  melanotic 
mass,  weighing  six  pounds,  situated  in  the  bronchial  lymphatic 
glands.  In  another  case  a  tumour  was  found  in  the  inguinal 
plexus  of  glands  weighing  above  eight  pounds,  which,  previous 
to  death,  pressed  upon  the  crural  nerves,  and  caused  paralysis. 
In  the  majority  of  cases,  however,  there  has  been  some  outward 
manifestation  of  the  disease ;  but  in  occult  disease  occurring  in 
grey  or  very  light  chestnut  horses,  the  practitioner  ought  to  con- 
sider whether  such  disease  may  not  be  due  to  melanotic  growths. 

The  development  of  melanosis  is  looked  upon  as  a  new  excre- 
tory function,  set  up  for  the  purpose  of  eliminating  from  the 
system  the  pigmentary  matter  which  is  no  longer  required  for 
the  purpose  of  tinging  the  hair.  If  it  were  true  that  the  pig- 
mentary matter  was  already  formed  in  the  blood,  and  only  re- 
quired to  be  appropriated  by  the  structures  to  which  it  gave  colour, 
the  supposition  would  be  justified ;  but  the  fact  is,  pigment  is 
not  conveyed  to  a  part,  but  is  formed  by  the  cells  of  the  tissues 
in  which  it  is  found,  out  of  materials  supplied  by  the  blood. 
We  must,  therefore,  look  upon  melanosis  as  being  due  to  an 
exalted  formative  power  in  tlie  cells  of  the  tissue  in  which  it  is 
found.  When  formed  in  the  skin  of  grey  horses,  we  can  easily 
understand  that  its  pigmentary  ceUs  may  be  stimulated  to  in- 


426  TUMOUKS. 

creased  activity  by  the  blood,  which  one  may  suppose  is  highly 
charged  with  the  ingredients  from  which  pigment  is  formed. 
This  would  be  merely  an  exalted  natural  action  of  the  cells ;  but 
when  the  pigmentary  matter  is  formed  by  the  cells  of  glands,  or 
other  structures  than  skin,  we  must  look  upon  the  process  as  a 
perverted  formative  action. 

Melanosis  appears  usually  as  a  rounded  tumour,  small  at  first, 
but  gradually  enlarging  in  every  direction  within  and  upon  those 
portions  of  the  body  which  do  not  lose  their  black  colour  by  age ; 
or  several  of  these  small  tumours  may  manifest  themselves  simul- 
taneously, enlarging  by  growth  and  by  coalescence,  and  thus  form- 
ing one  large  tumour.  Other  tumours  form  in  the  neighbourhood, 
and  usually  extend  along  the  direction  of  the  hairless  skin  of  the 
tail,  anus,  and  perinaeum,  until  at  last  there  is  a  most  unsightly 
collection  of  them,  like  bunches  of  large  onions.  After  a  time 
they  wither  in  their  centre ;  the  skin  ulcerates  by  a  slow,  degene- 
rate, and  non-suppurative  process — being  seemingly  converted 
into  melanotic  matter — and  allows  more  or  less  of  the  contents  of 
the  tumour  to  escape.  As  the  tumours  grow  the  natural  tissue  of 
the  part  withers,  its  place  being  taken  up  by  the  melanotic  matter. 

The  animal  does  not  seem  to  suffer  much  inconvenience,  except 
from  the  effects  of  friction  upon  the  surface  of  the  tumour  when 
it  comes  in  contact  with  contiguous  parts.  Thus  a  tumour  on 
the  tail  will  become  sore  if  it  presses  upon  another  tumour  on 
the  vagina,  or  if  by  its  weight  it  presses  heavily  upon  the  oppos- 
ing healthy  skin,  or  when  the  tumour  or  tumours  are  so  heavy  as 
to  prevent  the  animal  from  elevating  its  tail  during  progression. 

Without  entering  further  into  the  details  of  the  symptoms,  it 
may  be  concluded  that  a  black  tumour  in  any  part  of  the  body 
may  be  call'ed  melanosis. 

Melanotic  growths  are  neither  very  hard  nor  very  soft,  especi- 
ally the  external  ones.  Those  found  in  the  internal  parts  of  the 
body  are  much  softer.  The  colour  varies  in  shade  from  a  dark 
brown  to  the  deepest  black. 

Melanosis  is  generally  confined  to  aged  animals,  but  I  have 
seen  it  manifested  in  a  five-year-old  grey  horse,  and  become 
rapidly  developed  in  various  parts  of  the  body. 

The  treatment  of  melanosis  is  early  removal,  when  it,  as  well 
as  other  malignant  growths,  may  be  checked  for  a  time  ;  but,  as 
already  stated,  its  recurrent  nature  is  so  great  as  to  preclude  the 
hope  of  permanent  eradication. 


CHAPTEE  XXIII. 

BENIGN  TUMOURS. 

CLASSIFICATION — FIBROUS — POLYPI — INDURATED  ABSCESSES — EPIDER- 
MIC WARTS — CONDYLOMATA GRAPES LIPOMATA NEUROMATA 

ENCHONDROMATA CRUSTA    PETROSA CALCAREOUS OSTEO- 
PHYTES— OSTEO-SARCOMA CYSTIC,     BARREN    AND    PROLIFEROUS 

CYSTS GASEOUS,  SEROUS,  SYNOVIAL,  AND  MUCOUS  CYSTS CAPPED 

ELBOW — CAPPED  HOCK — OVARIAN  CYSTS — RANULA — BRONCHOCELE 

CUTANEOUS  AND  HAIR-BEARING  CYSTS CYSTIC  DISEASE  OF  THE 

FACIAL  SINUSES — DENTIGEROUS  OR  TEETH-BEARING  CYSTS. 

KON-MALIGNANT,  BENIGN,  OR  SIMPLE  TUMOURS. 

These  are  classified  as  sarcomatous  and  encysted — the  former 
being  solid,  the  latter  composed  of  a  cyst  containing  materials 
of  variable  consistence. 

I.  Sarcomatous  or  Solid  Tttmours. — There  are  several  varieties 
of  these  tumours  found  in  veterinary  practice,  the  most  common 
being  the  fibrous,  which  are  found  in  many  different  parts  of 
the  body,  differing  in  size  from  a  simple  wart  to  a  tumour  many 
pounds  in  weight. 

A  fibrous  tumour  usually  found  in  parts  which  contain  much 
fibrous  tissue,  is  slow  in  its  growth,  and  is  not  accompanied  by 
pain  or  tenderness  unless  accidentally  inflamed ;  is  of  a  hard, 
rounded  form,  with  its  surface  smooth  or  divided  into  lobes ;  gene- 
rally moveable,  and  contained  in  a  wall  of  areolar  tissue. 

The  most  familiar  example  is  the  suheutaneous  tvart.  These 
warts  are  of  various  sizes ;  some  as  small  as  a  pea,  others  as 
large  as  a  goose's  egg,  lodged  in  the  subcutaneous  areolar  tissue, 
singly  or  in  clusters.  They  differ  much  in  their  degree  of  con- 
nection with  surrounding  parts,  being  sometimes  firmly  attached 


428  BENIGN  TUMOURS. 

by  continuity  of  tissue,  at  other  times  loosely  imbedded  in  them, 
and  easily  moveable  beneath  the  skin.  Although  many  groups 
of  several  tumours  in  each  may  exist  in  the  same  structure  or 
organ,  it  is  very  rare  to  see  them  co-existent  in  separate  organs. 
They  have  very  few  vessels ;  indeed,  some  seem  to  have  no 
blood-vessels,  and  no  immediate  communication  with  the  sur- 
rounding parts,  but  are  lodged  in  a  sac,  and  derive  their  nourish- 
ment by  imbibing  nutrient  Huid  from  its  walls. 

The  tumours  are  composed  of  white  fibrous  tissue,  blended  with 
some  yellow  elastic  fibres,  closely  resembling  those  of  areolar  tissue. 
These  fibres  vary  in  their  different  stages  of  development,  and  are 
interlaced  together,  forming  very  compact  and  solid  masses.  At 
first  the  tumours  are  quite  unattached  to  the  skin,  but  as  they 
grow  they  burst  through  and  become  attached  to  it ;  and  from  their 
points  of  attachment  prolongations,  in  the  form  of  fungoid 
granulations,  rapidly  grow  from  the  surface.  Their  favourite 
seat  is  the  subcutaneous  areolar  tissue  of  the  inferior  surface  of 
the  abdomen,  where  they  are  generally  found  associated  with 
the  epidermic  wart.  When  the  skin  is  cut  through,  it  is  often 
discovered  that  a  large  number  of  them,  in  a  nest  of  condensed 
fibrous  tissue,  on  which  numerous  blood-vessels  ramify,  are 
lodged  in  the  areolar  tissue  of  this  part.  They  are  then  easily 
pressed  out  by  the  hand,  and  this  is  the  best  method  of  remov- 
ing them,  the  sac  being  afterwards  dressed  with  some  astringent, 
such  as  a  solution  of  sulphate  of  copper.  They  are  also  found 
in  the  uterus,  more  especially  of  the  bitch,  where  they  some- 
times contain  a  fluid  in  their  centre. 

Polypi  belong  to  the  fibrous  tumours,  consisting  of  tissue 
similar  to  that  of  the  last-named  form.  The  tumour  sketched 
in  Photo-lithograph,  Plate  IV.,  is  an  example  of  a  very  large 
nasal  polypus. 

A  polypus  may  be  defined  to  be  a  tumour  attached  by  means 
of  a  narrow  pedicle,  and  the  most  familiar  example  is  the  nasal 
polypus  attached  to  the  superior  part  of  the  nostril ;  of  a  softish 
consistence;  bleeding  when  injured;  often  containing  a  thin 
limpid  fluid  in  its  centre;  growing  downwards,  filling  the 
cavity  of  the  nostril,  causing  much  uneasiness  to  the  animal, 
and  interfering  very  materially  with  the  respiratory  func- 
tion. 

There  is  a  discharge  from  the  affected  nostril,  often  tinged 


FIBROUS  TUMOURS.  429 

with  blood,  especially  during  exercise  or  work.  The  animal 
makes  a  snuffling  sound  in  its  breathing,  and  frequently  sneezes. 
The  tumour  cannot  always  be  seen,  but  by  growth  becomes 
visible  to  the  examiner.  Sometimes  it  grows  in  the  contrary 
direction,  falls  into  the  isthmus  faucis,  and  is  apt  to  become 
temporarily  lodged  in  the  larynx,  causing  the  animal  to  breathe 
with  the  greatest  difficulty,  with  a  loud  roaring  sound,  and 
often  to  fall  down  from  exhaustion  and  want  of  breath.  By 
great  effort  the  animal  coughs  the  obstructing  tumour  from  the 
larynx  into  the  fauces  again,  and  all  at  once  the  roaring  sound 
and  difficulty  of  breathing  disappear.  Such  cases  are  termed 
"  Bellones  "  by  horse-coupers. 

The  only  treatment  for  polypus  is  removal;  and  the  best 
method  is  evulsion  by  the  forceps.  The  instrument  must  be 
passed  up  alongside  of  the  polypus  to  its  roots,  where  they 
must  be  fixed  by  strong  pressure  on  the  handles  ;  and  then  the 
connections  of  the  tumour  must  be  torn  by  a  compound  move- 
ment of  turning  and  pulling.  I  have  removed  them  very 
successfully  in  this  w^ay.  The  nostril  ought  to  be  afterwards 
frequently  syringed  with  an  astringent  wash,  such  as  a  solution 
of  the  tincture  of  the  perchloride  of  iron. 

When  the  polypus  grows  into  the  fauces,  it  is  quite  possible 
to  remove  it — if  it  can  be  discovered  by  the  hand — by  enclosing 
its  pedicle  in  a  noose  of  strong  wire,  and  tearing  it  away  by 
strong  and  continuous  traction.  If  it  were  possible  to  apply 
the  "  Ecraseur,"  the  removal  of  this  polypus  would  be  rendered 
a  very  easy  matter.  Fibrous  tumours,  similar  to  polypi,  are 
found  in  the  ventricles  of  the  brain. 

Fibrous  tumours,  especially  in  the  horse,  are  often  due  to  the 
imprisonment  of  pus  in  the  deep-seated  inter-muscular  structures. 
For  example,  an  apparently  fibrous  tumour,  with  well-defined 
borders,  and  no  appearance  of  inflamm.ation,  is  often  found  in  the 
inferior  cervical  region,  beneath  the  levator  humeri  muscle.  It 
arises  from  the  pressure  of  the  collar,  and  when  cut  into, 
will  be  found  to  consist  of  the  enormously  thickened  walls  of 
an  old  abscess — small  in  itself,  and  containing  a  little  pus. 
Again,  these  tumours  may  be  found  upon  those  portions  of  the 
horse's  sides  that  are  liable  to  be  bruised  by  the  shaft  of  the  cart. 
Indeed,  with  the  exception  of  the  subcutaneous  tumours  already 
described,  the  majority  of  the  so-called  fibrous  tumours  of  the 


430 


BENIGN  TUMOURS. 


horse  are  due  to  the  presence  of  pus  too  deeply  seated  to  find 
its  way  to  the  surface. 

These  old  abscesses  may  be  removed  either  by  excision  of 
the  whole  mass,  or  by  destruction  with  caustics.  If  not  very 
large,  perhaps  the  latter  is  the  quicker  method ;  but  if  very 
large,  the  knife  must  have  the  preference.  It  is  quite  useless 
to  attempt  their  reduction  by  the  use  of  external  stimulants 
such  as  iodine  or  blisters. 


II. — EPIDERMIC  AND  EPITHELIAL  TUMOURS 

Form  a  class  of  new  formations  of  much  interest,  and  are  of 
frequent  occurrence.  Warts  (Verrucse)  on  the  skin  and  on  the 
mucous  membranes  are  instances  of  them.     Warts  consist  of  a 

thickening  of  the  epidermis,  pro- 
duced by  accumulation  of  its  scales, 
with  hypertrophy  of  the  papillse  of 
the  true  skin. 

These  growths  are  found  most 
commonly  in  young  animals,  their 
favourite  seat  beinsf  the  under  sur- 
face  of  the  abdomen,  the  genitals, 
mammary  glands,  lips  and  eyelids. 
In  the  dog  they  are  often  seen  in 
large  numbers  within  the  mouth, 
appearing  in  a  very  short  space  of 
time,  and  disappearing  as  quickly. 
"Wlien  they  form  on  mucous  mem- 
branes, or  when  found  about  the 
anus,  they  are  called  condylomata. 
They  are  of  the  same  nature,  but 
are  softer  in  consistence  than  the 
wart. 

They  may  be  removed  by  exci- 


FiG.  100. — Perpendicular  section 
of  a  papilla,  from  an  acuminated 
condyloma,  after  the  addition  of 
acetic  acid.  a.  Vascular  loop,  in- 
ternal to  which  is  fibrous  tissue, 
forming  the  axis  of  the  papilla. 
Outside  are  nuclei,  b.  h.  Basement 
membrane,  c.  c.  Epidermic  cells. 
250  diam. — (Wedl.) 


sion  or  torsion ;  twisting  or  pulling 
by  the  hand  being  very  often  sufficient.  If  they  are  found 
within  the  sheath  of  the  penis,  or  on  the  prepuce  surrounding 
the  orifice  of  the  urethra,  the  patient  has  to  be  cast,  and  the 
whole  mass  of  them  removed  by  the  cautery  or  knife,  and  their 
seat  cauterised.     If  this  be  not  done,  they  are  apt  to  grow  again. 


EPIDERMIC  AND  EPITHELIAL  TUMOURS. 


431 


Warts  sometimes  grow  to  an  immense  size,  and  hang  like 
bunches  of  onions  below  the  animal's  belly ;  when  cut  into,  they 
are  found  not  only  to  be  warts,  but  also  steatoma,  or  the  subcuta- 
neous fibrous  tumours  already  described.  Indeed,  when  this 
kind  of  tumour  breaks  through  the  skin,  it  very  closely  resembles 
a  common  wart.  They  are  found  in  horses  and  cattle,  and  most 
commonly  in  young  animals. 

When  in  the  mouth  of  the  dog,  they  may  be  snipped  off  with  a 
pair  of  scissors ;  their  removal  in  this  way  is  not  succeeded  by 
much  haemorrhage,  or  the  mouth  may  be  washed  twice  or  thrice 
a  day  with  vinegar,  which  seems  to  have  a  wonderful  effect  in 
destroying  them.  When  on  the  eyelid,  their  removal  must  be 
performed  with  great  caution,  or  the  animal  may  be  damaged  for 
life.  Gentle  and  repeated  touches  with  an  acid,  so  as  to  destroy 
a  thin  pellicle  at  a  time,  is  the  best  method  for  their  removal 
when  so  situated. 

The  "grapes"  of  chronic  grease  are  similar  to  warts,  con- 
sisting of  thickened  epidermis  and  of  enlarged  papillae  and 
sebaceous  follicles ;  they  are  best  removed  with  the  actual 
cautery;  shaved  off,  in  fact,  by  a  sharp-edged  piece  of  iron 
heated  to  a  red  heat. 

Another  kind  of  epithelial  tumour  is  found  in  the  vagina, 
especially  of   the   bitch,    larger    than    a    wart,    with  a  lobu- 

lated  surface,  and  much  vascu- 
larity, having  a  tendency  to  bleed. 
Several  of  these  vegetations  by  con- 
fluence form  a  large  tumour ;  they  are 
to  be  removed  by  being  enclosed  in 
a  clam,  and  cut  off  by  the  cautery. 
They  may  be  named  as  vascular  epe- 
thelial  tumours. 


Fia.  101. — Fat  cells,  from  tum- 
our removed  from  vagina  of  a 
cow  by  Mr.  Cartwright  of  Whit- 
church. Case  described  in  Veter- 
inarian  for  March  1872.  200 
diam. 


III. — FATTY  TUMOURS  OR  LIPOMATA, 

Consist  of  normal  fat  cells  packed  to- 
gether. They  occasionally  attain  a  very 
large  size.  ^ 


When  situated  externally, 


^  A  case  of  this  nature  occtirred  in  the  practice  of  Mr.  Cunningham  of  Slateford, 
•where  the  tumour  weighed  236  lbs.  It  involved  the  liver,  spleen,  and  mesentery, 
and  was  found,  microscopically,  to  be  composed  of  fat  cells ;  although  externally, 


432  BENIGN  TUMOURS. 

they  must  be  removed  by  excision,  and  the  sac  destroyed  by  a 
slight  touch  of  the  actual  cautery  or  a  caustic  wash.  Vaginal 
tumours  sometimes  consist  of  fat  cells.  The  tumour  from 
which  the  microscopic  view  is  taken  weighed  2  lbs.  5  oz.,  and 
was  removed  from  the  vagina  of  a  cow  by  Mr.  Cartwright  of 
Whitchurch. 


IV. — NEUROMATOUS  TUMOURS. 

The  term  neuroma  is  applied  to  a  fibrous  tumour  connected 
with  the  nerves.  In  the  human  being  they  are  of  frequent 
occurrence,  several  hundreds  of  them  being  found  in  one  sub- 
ject ;  but  in  the  lower  animals  I  know  of  only  one  set  of  nerves 
upon  which  they  appear,  and  as  the  result  of  an  operation, 
namely,  upon  the  plantar  nerves,  after  their  division  for  foot 
lameness. 

These  tumours  appear  within  an  indefinite  period  after  the 
operation  (neurotomy) ;  in  one  case  four  years  had  elapsed 
before  they  began  to  form.  They  are  of  a  solid  firm  consistence, 
composed  of  a  fibrous  stroma,  the  fibres  of  which  have  a  wavy 
outline,  running  parallel  to  or  interlacing  with  one  another, 
and  having  scattered  throughout  them  numerous  groups  of  cells 
more  or  less  closely  packed  together.  Eokitansky  says — 
"  These  tumours  lie  between  the  fasciculi  of  the  nerve,  and  are 
interwoven  with  their  neurilemmatous  sheath ;  and  it  is  a 
remarkable  and  no  less  important  general  rule,  because  of  the 
symptoms  which  may  result  from  its  presence,  or  which  may  be 
set  up  by  operations  performed  on  it,  that  neuroma  is  never 
deposited  in  the  centre  of  a  nerve,  but  at  its  side,  so  that  only  a 
small  part  of  its  fasciculi  is  displaced.  The  displaced  fasciculi 
are  spread  abroad  and  stretched  over  the  tumour,  while  the 
greater  mass  of  the  nerve  remains  on  the  other  side  uninjured, 
and  with  its  fibres  in  connection  with  one  another." 

These  tumours  are  found  as  rounded  or  oval  bodies,  with 
their  long  diameter  along  the  course  of  the  nerve ;  varying  in 
size,  but  never  very  large ;  moveable  in  the  transverse  but  not  in 
the  long  direction.     They  are  always  on  the  superior  division 

and  to  the  naked  eye,  it  presented  characters  simulating  those  of  a  malignant 
disease.  I  had  an  opportunity  of  seeing  the  horse,  a  two-year-old  carting  gelding, 
both  before  and  after  death. 


NEUROMATOUS  TUMOURS.  433 

of  the  cut  nerve.  They  sometimes  cause  great  pain,  manifested 
more  particularly  when  the  horse  is  standing  still.  He  will 
then  often  lift  his  foot  from  the  ground,  as  if  the  pain  were 
lancinating;  but  the  lameness  is  not  so  evident  when  he  is 
made  to  move.  When  the  tumour  is  pressed  upon,  or  handled 
in  any  way,  the  patient  evinces  acute  agony.  Sometimes,  how- 
ever, these  tumours,  although  of  some  magnitude,  cause  no  in- 
convenience ;  but  they  are  apt  to  be  struck  by  the  opposite  foot, 
and  so  cause  the  animal  almost  to  fall  to  the  ground.  They 
sometimes  make  their  appearance  in  a  short  time  after  the 
operation  of  neurotomy,  and  are  the  result  of  a  badly  performed 
operation;  the  operator  having  divided  the  nerve  below  the 
upper  angle  of  the  wound  in  the  skin,  thus  leaving  a  portion 
of  it  in  the  wound,  which,  becoming  embraced  in  the  reparative 
material,  forms  a  nucleus  for  the  growth  of  the  neuroma. 
The  only  treatment  is  excision  by  the  knife. 


V. — CARTILAGINOUS  TUMOURS,  OR  ENCHONDROMATA. 

These  may  take  place  in  the  soft  parts,  or  in  bone;  their 
favourite  seat  being  the  region  of  the  sternum,  or  upon  the  ribs. 
They  are  frequently  caused  by  external  injury.  There  are  two 
forms  of  them;  one  being  round  or  oval,  with  well-defined 
borders,  and  the  other  having  no  well-defined  limits,  but  resem- 
bling an  infiltration  into  the  surrounding  structures.  In  the 
latter  case  it  will  generally  be  found  that  the  tumour  arises  from 
the  development  and  growth  of  cartilage  in  an  inflammatory 
exudate ;  and  wounds  involving  the  sternum  are  very  apt  to  be 
accompanied  by  this  complication. 

To  the  touch  these  tumours  are  hard  and  dense,  but  present 
a  slight  elasticity.  They  gradually  increase  in  size,  and  when 
on  the  sternum  become  a  source  of  hindrance  to  the  animal's 
movements,  causing  him  to  move  with  the  fore  legs  wide  apart, 
and  with  apparent  stiffness  in  the  gait.  The  skin  over  the  en- 
largement soon  becomes  raw  by  the  friction  of  the  elbow  on  its 
surface. 

The  rounded  form  of  tumour  generally  appears  on  the  carini- 
form  cartilage  as  a  globular  enlargement,  hard  and  firm  to  the 
touch,  causing  little  or  no  inconvenience  to  the  animal,  unless 
interfered  with  by  the  collar. 

2f 


434 


BENIGN  TUMOURS. 


I  am  noi  aware  that  these  tumours  grow  witliin  the  shell  of 
a  bone,  as  in  the  human  being,  but  on  the  outside,  and  gene- 
rally fastened  to  the  bony  wall  and  invested  by  the  periosteum, 
which  is  greatly  thickened  and  overgrown.     When  cut  with 

the  knife,  they  present  a  bright, 
greyish,  translucent,  or  pinky- white 
appearance,  and  sometimes  coarsely 
granular,  or  opaque,  with  gritty  points, 
as  if  gradually  ossifying.  When  ex- 
amined microscopically,  they  are 
found  to  consist  of  cartilage  cells, 
mixed  with  fibres  of  white  fibrous 
tissue.  The  fibres  are  very  deli- 
cate and  tufted,  and  contain  the 
cartilage  cells,  either  singly  or  in 
groups. 
Fig.  102.— Proliferation   of       The    Only   change    that    occurs    in 

diseased      cartilage.         Large    tllCSC   tumOUrS  is  their  OSsification   iuto 
groups  of  cartilage  cells  witliin  ,,  .         ,  i         i     • 

a  common  envelope  (wrongly  a  canccllous    Structure   enclosed   m  a 

called  parent  cells),  produced    thin    COmpact    shell    of   boUC.      I    have 
from  single  cells  by  successive  .,         „   .  .         , 

subdivisions.    At  the  edge  one  never  Seen  the  tatty  degeneration  or 
of  these  groups  has  been  cut  cvstic    transformation    spoken    of    by 

through,   and  in  it  is  seen  a      '^  jt     i       •   j         i     \     ••     • 

cartilage    cell    invested    by   a    human    pathologists;    but    it    IS    quite 


number  of  capsular  layers  (ex- 
ternal secreted  masses).  300 
diam.  —  (Vircho  w. ) 


possible    that    such    a    change 
occur. 


may 


■  in 


Fig.  103.  Fig.  104. 

Figs.  103  and  104.  —  Enchondroma.  Fig.  100.  Structure  of  a  firm  enchondroma. 
The  right  of  the  figure  represents,  above,  mineral  deposit  in  and  around  the  cells  ; 
and,  below,  some  isolated  cartilage  corpuscles.  FiG.  101.  The  same,  after  the 
addition  of  acetic  acid,  rendering  the  whole — and  especially  the  nucleus — more 
transparent.     250  diam. — (Bennett.) 

Treatment. — The  only  method  is  their  removal  by  excision, 
and  that  as  early  as  possible. 


CRUSTA-PETBOSA  TUMOURS. 


435 


VI. — CRUSTA-PETROSA  TUMOURS. 


Fig.  105. 


The  above  drawing  represents  a  section  of  a  tumour  now  in 
the  Veterinary  College  Museum,  composed  of  crusta-petrosa, 
attached  to  one  of  the  molars  of  the  ox.  I  have  no  history  of 
the  case ;  but  upon  examination  find  that  the  attached  tooth  is 
the  last  molar  of  the  upper  jaw. 

At^.  the  tooth  is  represented  with  its  table  running  obliquely 
downwards  towards  C,  and  its  crown  lost  in  the  adventitious 
substance.  B.  The  shining  surface  of  the  section,  and  G.  the 
crown  surface  of  the  tumour,  slightly  worn  upon  its  inferior 
aspect  by  contact  with  the  teeth  of  the  opposing  jaw.  The 
tumour  weighs  1  lb.  3  oz. 

Tomes  describes  a  similar  condition  of  the  crusta-petrosa  under 
the  term  dental  exostosis  or  hypertrophy  of  the  cementum,  and 
he  says — "  It  will  not  be  forgotten  that  the  surfaces  of  the  fangs 
of  teeth  are  coated  with  a  thin  layer  of  cementum.  Under 
certain  circumstances  this  layer  becomes  increased  in  thickness 
by  additions  on  the  external  surface.  The  newly  added  cemen- 
tum is  in  every  way  similar  in  structure  to  that  previously  form- 
ing part  of  the  tooth."  He  again  says — "In  dental  exostosis 
the  amount  of  new  cementum  may  be  very  slight,  or  may  be 
considerable  in  quantity.  The  affected  fang  may  be  but  little 
enlarged,  or  it  may  be  increased  to  twice  its  natural  size.  Near 
about  the  end  of  the  fang  is  the  most  common  situation  to  find 
the  greatest  amount  of  cementum ;   but  you  seldom   find  an 


436  BENIGN  TUMOURS. 

increase  on  one  side  of  the  fang  only,  unless  the  opposite  side 
has  been  exposed  by  the  absorption  of  the  gum,  or  deprived  of 
its  periosteal  covering.  In  some  cases  nodules  of  cementum  are 
found  in  various  parts  of  the  fang,  even  near  the  neck  of  the 
tooth."  And  he  concludes  that  "  dental  exostosis  is  caused  by 
that  condition  of  the  periosteum  which  is  called  irritation — a 
state  usually  induced  by  pre-existing  disease  in  other  dental 
tissues,  and  in  a  great  majority  of  cases  by  caries — not  always, 
however." — {Dental  Physiology  and  Surgery,  by  John  Tomes, 
Surgeon-Dentist  to  the  Middlesex  Hospital.) 


VII. — CALCAREOUS  TUMOURS. 

These  consist  of  a  deposit  of  calcareous  salts  in  various  parts 
of  the  body — in  the  testicle,  parenchyma  of  organs,  upon  nerves, 
&c. 

I  have  seen  a  concretion  of  this  kind  in  the  substance  of 
the  liver,  causing  fatal  haemorrhage  by  forcing  its  way  through 
Glisson's  capsule. 


VIII. — OSSEOUS  TUTMOURS  AND  OSTEOPHYTES 

Are  very  irregular,  of  a  warty  stalactic  shape,  and  are  common 
in  the  neighbourhood  of  joints  where  the  articular  surface  is 
affected  with  caries,  and  sometimes  surround  the  tendons  of  a 
limb  when  no  joint  disease  is  present. — (See  Photo-lithograph, 
Plate  I.,  Fig.  4.) 

They  result  from  the  ossification  of  an  exudate  which  has 
been  formed  in  consequence  of  some  cause  of  inflammation. 
Osseous  tumours  are  of  a  more  compact  structure  than  osteo- 
phytes, and  grow  more  from  the  compact  structure  of  the  bone 
itself  Cases  of  great  lameness  sometimes  occur  from  these  new 
formations  becoming  inflamed  from  accidental  causes,  and  I 
have  seen  necrosis  of  them  produce  sloughing  of  the  skin,  and 
the  formation  of  sinuses. 


IX. — OSTEOID  TUMOURS — OSTEO-SARCOMA. 

(See  Photo-lithograph,  Plate  I.,  Pig.  9.) 

These  are  tumours  of  irregularly  protuberant  surface,  affect- 
ing both  the  upper  and  lower  jaws  of  horned  cattle.     They  are 


OSTEOID  TUMOURS.  437 

generally  of  a  slow,  but  sometimes  of  a  rapid  growth.  They 
consist  of  a  cancellous  bony  tissue,  forming  trabeculse,  which 
surround  spaces  filled  with  a  greyish  white,  vascular,  fibrous 
material,  in  which  a  sparing  quantity  of  cells  and  nuclei  are 
imbedded. 

These  tumours  may  vary  in  their  density,  from  the  presence 
of  more  or  less  bony  structure  in  their  formation. 

The  origin  of  osteo-sarcoma  is  very  obscure,  but  it  seems  to 
depend  upon  the  tubercular  diathesis,  as  upon  dissection  the 
various  structures  adjoining  the  tumour  are  usually  found  matted 
together,  and  firmly  adherent  to  it,  whilst  spots  of  tubercular 
matter  may  be  found  here  and  there  scattered  throughout  its 
substance. 

The  only  treatment  that  can  be  recommended  is  the  removal 
of  the  tumour  at  its  very  earliest  stage,  and  before  it  has  attained 
any  size.  If  it  be  of  any  magnitude  no  treatment  should  be 
attempted,  but  the  animal  ought  to  be  fed  for  slaughter,  if  not 
already  fit.  These  tumours  do  not  seem  to  cause  much  pain  or 
inconvenience  for  a  long  time,  and  hence  the  animal  will  feed 
well  enough. 

X. — CYSTIC  TUMOURS. 

These  tumours  are  divided  by  Paget  into  simple  or  barren, 
and  compound  or  proliferous,  the  former  containing  inorganized 
matter  or  fluid,  the  latter  various  organized  bodies. 

The  barren  cysts  contain  a  fluid-like  serum,  such  as  that 
found  in  serous  abscesses  (capped  elbow  and  capped  hock),  or 
synovia- like  fluid,  as  in  the  enlarged  bursse  (wind-galls) ; 
whilst  others  contain  a  more  highly  organized  fluid,  as  in 
ranula. 

These  cysts,  according  to  the  same  authority,  have  at  least 
three  modes  of  origin.  1st.  Some  are  formed  by  the  enlarge- 
ment and  fusion  of  the  spaces  or  areolae  of  the  connective  or 
other  tissues.  In  these  spaces  fluids  accumulate ;  the  tissues 
become  rarefied,  and  gradually  the  boundaries  of  the  spaces  are 
levelled  down  and  walled  in,  till  a  perfect  sac  or  cyst  is  formed, 
the  walls  of  which  continue  to  secrete. 

2d.  Some  cysts  are  formed  by  dilatation  and  growth  of  natural 
ducts  or  sacculi,  as  are  those  sebaceous  or  epidermal  cysts, 
which,  formed  by  hair  follicles,  have  permanent  openings.    Such 


438  BENIGN  TUMOURS. 

are  also  certain  cysts  containing  milk  that  are  formed  of  enlarged 
lactiferous  tubes,  such  as  the  ovarian  cysts,  formed  by  the  over- 
grown Graafian  vesicles;  and  such  appear  to  be  certain  cysts 
formed  of  dilated  portions  of  blood-vessels  shut  off  from  the  main 
streams. 

Sd.  Many,  and  perhaps  the  great  majority  of  cysts,  such  as 
those  of  the  kidney,  the  choroid  plexuses,  the  chorion,  and  the 
thyroid  gland,  are  formed  by  the  enormous  growth  of  new  ele- 
mentary structures,  having  the  character  of  cells  or  nuclei,  which 
pursue  a  morbid  course  from  their  origin,  or  from  a  very  early 
period  of  their  development. 

Simple  or  barren  cysts,  as  they  occur  in  veterinary  practice, 
may  be  divided  into  gaseous,  serous,  synovial,  and  mucous. 

Gaseous  cysts  have  been  observed  by  Hunter  on  the  intes- 
tines of  pigs.  I  have  frequently  seen  them  on  the  intestines 
of  dogs.  A  cyst  of  this  kind  often  forms  on  the  hind  quarters 
of  horses,  in  the  region  of  the  trochanter  major  of  the  femur, 
which  does  not  seem  to  contain  any  fluid  when  cut  into,  and 
upon  dissection  presents  a  mere  cavity,  lined  by  a  glistening  grey 
membrane.  It  can  be  distinctly  observed  in  the  living  animal 
Can  the  term  wind-gall,  as  applied  to  distended  synovial  bursse, 
have  arisen  from  the  fact  that  this  cyst  seemingly  contained 
nothing  but  air  ? 

Serous  cysts  arise  in  two  ways: — 1st.  From  the  effects  of 
pressure ;  and  2d.,  without  evident  cause.  To  the  first  belong 
capped  hock,  capped  elbow,  and  other  so-called  serous  abscesses. 

Serenes  abscesses  are  soft  tumours,  formed  by  an  effusion  of  serum 
into  the  areolae  of  the  connective  tissue  of  the  part,  which  be- 
comes condensed,  and  marks  out  the  limits  of  the  cyst.  Within 
the  cyst  the  fibrous  trabeculse,  or  bands  of  connective  tissue,  are 
gradually  absorbed,  and  give  place  to  the  effusion,  until  at  last 
a  cavity  is  formed,  which  is  filled  with  serum,  and  lined  by  a 
more  or  less  perfect  epithelium.  In  some  serous  abscesses,  more 
particularly  if  caused  by  great  pressure  or  friction,  inflammatory 
products  are  formed,  which  become  consolidated;  or  a  per- 
fectly formed  cyst  may  inflame,  and  become  converted  into  a 
solid  tumour.  In  others  again,  the  areolar  structure  is  not  so 
completely  removed,  and  the  serosity  will  be  found  in  various 
alveoli  or  spaces,  giving  to  the  tumour  a  honeycomb  appearance 
when  cut  into. 


CYSTIC  TUMOURS.  439 

Wlien  on  the  elbow,  the  best  treatment  is  the  reduction  of 
tlie  tumour  by  puncture ;  the  cavity  afterwards  injected  with  a 
solution  of  sulphate  of  zinc,  or  of  iodine,  and  the  orifice  of 
puncture  kept  open  until  the  cavity  of  the  cyst  has  become 
obliterated.  Another  plan  is  to  excite  the  suppurative  action 
in  it  after  it  has  been  punctured,  by  injecting  a  stimulating 
mixture,  as  ammonia  and  oil,  or  by  inserting  a  seton  through 
its  centre.  It  is  useless  to  puncture  and  allow  the  wound  to 
close  immediately,  for  the  Avails  of  the  sac  have  acquired 
secreting  properties,  and  continue  to  pour  out  the  serosity,  which 
will  speedily  fill  the  cavity  of  the  cyst.  It  is  therefore  necessary 
to  keep  the  puncture  open  until  the  walls  of  the  sac  have  be- 
come adherent  to  each  other,  and  its  cavity  destroyed. 

When  the  cyst  has  become  consolidated  by  the  causes  already 
given,  it  will  often  be  found  that  a  little  suppuration  occurs  in 
the  centre  of  the  tumour ;  but  it  is  never  very  extensive,  and 
the  suppurative  spot  is  surrounded  by  a  thick  wall  of  condensed 
fibrous  tissue  of  a  greyish  appearance. 

There  are  two  ways  of  removing  the  tumour  when  in  this 
condition — by  excision,  and  by  sloughing  it  with  escharotics. 
I  have  tried  both  plans,  and  prefer  the  latter,  provided  it  is 
carefully  done.  I  puncture  the  tumour  in  two  or  three  places, 
and  insert  into  each  puncture  a  very  small  quantity  of  finely 
powdered  corrosive  sublimate  and  arsenic,  in  equal  parts,  rolled 
up  in  a  small  piece  of  tissue  paper.  The  effect  of  this  is  two- 
fold:— (1st.)  It  destroys  the  vitality  of  the  tissue  which  it 
touches;  and  (2d.)  Excites  absorption  throughout  the  whole 
extent  of  the  tumour.  The  absorption  first  excited  in  the  living 
structures  in  immediate  contact  with  those  destroyed  by  the 
agent,  whereby  a  line  of  demarcation  is  formed  between  the 
living  and  dead  tissue,  becomes  general  throughout  the  tumour, 
and  in  a  few  days  it  will  be  seen  that  it  has  diminished  in 
volume  in  every  direction.  After  the  sloughs  caused  by  the 
escharotics  have  been  removed,  the  parts  should  be  kept  clean 
for  a  few  days,  at  the  end  of  which  it  may  be  necessary  to  reapply 
the  caustic. 

If  excision  with  the  knife  be  preferred,  the  operator  must 
make  his  incision  in  the  perpendicular  direction  only,  as  a 
crucial  incision  leaves  an  ugly  blemish.  Two  incisions  parallel 
to  each  other  may  be  required  in  very  large  tumours,  and  about 


440  BENIGN  TUMOURS. 

an  inch  apart,  in  order  to  remove  a  portion  of  the  skin,  which, 
if  left,  would  be  an  ugly  blemish. 

Capped  elbow  is  caused  by  the  animal  lying  upon  the  heels 
of  his  shoe,  and  is  apt  to  be  produced  by  a  shoe  too  long  in  the 
heels.  It  must  therefore  be  remembered  that  the  application 
of  proper  shoes  is  the  first  step  in  the  treatment,  and,  in  addi- 
tion, that  a  pad  or  bandage  should  be  placed  around  the  foot, 
in  order  to  prevent  any  chance  of  bruising  during  the  period 
of  treatment,  and  for  some  time  after  recovery.  Some  horses 
will  cap  their  elbows,  no  matter  how  carefully  they  are  shod, 
and  these,  whilst  in  the  stable,  should  always  have  a  boot 
or  pad  to  cover  the  heels  of  the  shoe  and  posterior  parts  of 
the  foot. 

The  treatment  for  capped  hock  is  a  more  difficult  matter,  for 
unless  great  care  be  taken,  a  small  enlargement  on  the  point  of 
the  OS  calcis — of  a  soft  pliable  nature — may  become  converted 
into  a  hard,  solid,  and  unsightly  swelling,  which  will  lessen  the 
value  of  the  animal  to  a  very  great  extent. 

Serous  capped  hocks  are  most  frequently  seen  in  well-bred 
horses,  whilst  capped  elbows  prevail  amongst  those  of  a  coarser 
breed.  Xot  that  there  is  any  special  predisposition  in  either 
class  of  animal,  but  from  the  facts  that  coarse  horses  are  shod 
with  turned-up  or  long  heels,  and  that  the  well-bred  ones  are 
liable  to  accidents  to  the  points  of  the  hocks  from  kicking  in 
harness  or  in  the  stable,  being,  as  a  rule,  more  restless  at  night 
than  the  coarser-bred  horse. 

Some  horses  have  a  habit  of  scraping  all  their  bedding  from 
under  them,  and  of  lying  upon  the  bare  floor  of  the  stall.  Such 
are  very  frequently  seen  \vith  the  points  of  their  hocks  enlarged. 
I  always  look  with  suspicion  upon  horses  with  this  blemish,  as 
generally  it  is  indicative  of  some  vice. 

If  the  enlargement  is  not  very  unsightly,  it  should  be  left 
alone;  if  there  is  any  heat  of  skin  and  inflammation,  the  appli- 
cation of  cold  to  the  part  and  the  administration  of  a  purgative 
will  constitute  the  best  treatment.  But  if  the  sac  be  large  and 
the  hock  unsightly,  the  insertion  of  a  seton  tlirough  it,  not 
merely  between  it  and  the  skin,  will  occasionally  reduce  it. 
There  is  no  danger  in  this,  for  there  is  no  synovial  cavity 
interfered  with  in  any  way.  The  seton  should  remain  in  for 
a  fortnight,  but  no  longer,  as  it  is  apt,  if  kept  in  too  long,  to 


CYSTIC  TUMOURS.  441 

produce  considerable  thickening  of  the  subcutaneous  tissues  of 
the  parts  surrounding  its  course.  The  cyst  sometimes  becomes 
consolidated,  either  from  the  treatment  employed  for  its  removal, 
or  from  some  other  cause.  The  repeated  application  of  iodine, 
or  its  combination  with  mercury,  will  often  reduce  it  very  con- 
siderably. In  some  cases  a  strong  application,  such  as  one  dram 
of  the  biniodide  of  mercury  to  the  ounce  of  lard,  will  answer ; 
in  others,  a  frequent  application  of  a  milder  preparation  will 
do  best.  I  have  found  the  following  a  very  nice  remedy: — 
Hydrargyrum  biniod.,  one  drachm;  water,  twelve  ounces;  and  a 
sufficient  quantity  of  the  iodide  of  potassium  to  dissolve  the 
biniodide.  This  is  to  be  applied  once  or  twice  a  day  until 
slight  soreness  is  produced,  and  reapplied  when  the  soreness 
disappears.  If  possible,  the  horse  should  be  turned  out  to  grass, 
or  kept  in  a  thickly  bedded  box  during  treatment. 

Cysts  upon  the  hock  or  elbow,  or  indeed  upon  any  part  of 
the  body,  if  they  do  not  cause  lameness,  are  not  to  be  looked 
upon  as  unsoundness. 

A  form  of  capped  hock  arising  from  disease  of  the  os  calcis, 
and  an  unsoundness,  has  been  already  described  (page  312). 

In  some  rare  instances  collections  of  fluid-forming  cysts  occur 
in  front  of  the  patella,  the  knees,  and  other  parts  of  the  body. 
They  may  be  opened  with  safety. 

In  horned  cattle  immense  cysts  form  in  front  of  the  knees, 
caused  by  the  animal  being  compelled  to  lie  upon  a  hard  floor. 
A  seton  through  their  substance,  and  the  application  of  a  bandage, 
to  prevent  bruising  whilst  the  patient  is  lying  down,  will  gene- 
rally remove  them. 

Serous  cysts  form  in  the  ovaries,  mammary  glands  of  bitches, 
in  the  thyroid  body  of  all  our  patifents,  and  in  the  facial  sinuses 
of  the  horse  and  ox. 

The  cystic  growths  which  are  found  in  the  ovaries  are  either 
simple  or  unilocular,  compound  or  multilocular ;  sometimes 
scarcely  increasing  the  normal  size  of  the  ovary,  which  is  found 
to  have  lost  its  natural  structure,  and  its  place  taken  up  by  a 
number  of  small  cysts ;  they  are  supposed  to  result  from  dis- 
tention of  the  Graafian  vesicles  by  a  morbid  increase  of  their 
contents.  In  other  cases  the  cystic  growths  attain  an  immense 
size,  and  hold  a  large  quantity  of  fluid,  which  distends  the 
cavity  of  the  abdomen,  and  presents  a  swelling  externally  which 


442  BENIGN  TUMOURS. 

fluctuates  on  pressure.  This  form  of  dropsy  is  common  in 
bitches.  The  treatment  is  by  tapping  (paracentesis),  and  after- 
wards injecting  the  tincture  of  iodine  through  the  canula.  I 
have  repeatedly  performed  this  operation  with  success.  I  gene- 
rally introduce  the  trocar  as  near  the  base  of  the  tumour  as 
possible,  and  send  it  upwards  obliquely  through  the  skin  and 
subcutaneous  tissues.  The  limits  of  the  tumour  in  bitches 
may  be  very  well  defined  by  a  careful  external  manipulation. 

In  the  cow  small  ovarian  cysts  are  sometimes  a  cause  of  nym- 
phomania. Their  presence  can  be  detected  by  an  examination 
per  rectum,  which  must  be  thoroughly  emptied,  and  the  hand, 
being  introduced  into  it,  is  passed  over  the  uterus  until  it  reaches 
the  ovaries.  The  diseased  ovary  is  larger  than  the  healthy  one, 
is  irregular  and  lumpy  on  its  surface,  and  more  or  less  elastic. 
Moderate  compression  will  cause  rupture  of  the  cysts.  On  the 
following  day  there  may  be  increased  excitement,  with  trifling 
fever;  but  with  quiet  and  a  light  diet  these  soon  disappear. 
Goetz  avers  that  tubercular  masses  in  the  ovaries  may  be  dis- 
pelled in  the  same  manner. — ( Veterinary  Journal) 

Ovarian  dropsy  has  also  been  seen  in  the  cow  and  in  the 
mare. 

Cysts  in  connection  with  mucous  membranes  and  glands  are 
termed  "  mucous  cysts,"  and  may  be  witnessed  occasionally  in 
the  mouths  and  on  the  lij)s,  as  well  as  in  the  vicinity  of  the 
eyes,  of  the  lower  animals.  I  have  seen  that  form  called  ranula, 
which  is  a  sac  containing  a  glairy  fluid,  situated  under  the 
tongue,  on  either  side  of  the  frsenum.  It  impedes  the  move- 
ments of  the  tongue,  and  causes  the  patient  to  froth  at  the 
mouth.  It  requires  to  be  removed  by  a  pair  of  scissors,  and  the 
cavity  touched  with  caustic.  Pointer  and  setter  dogs  are  subject 
to  ranula. 

Cysts  in  the  thyroid  body  constitute  bronchocele;  they  are 
said  to  be  caused  by  the  water  which  the  animals  drink,  and 
that  if  the  water  be  changed  they  will  disappear.  But  I  have 
some  doubt  as  to  the  truth  of  the  statement  that  bronchocele 
is  solely  caused  by  tlie  presence  of  magnesian  lime  in  the  water, 
as  I  have  seen  well-marked  cases  in  young  foals,  and  in  large 
flocks  of  lambs,  where  this  could  not  possibly  be  the  cause. 
Doubtless  it  is  found  most  abundantly  on  the  magnesian  lime- 
stone formations ;  but  it  cannot  be  denied  that  low  situations. 


CYSTIC  TUMOURS.  443 

or  a  damp  atmosphere  upon  elevated  situations,  will  act  as  causes 
of  broncho cele. 

It  is  detected  by  a  soft  fluctuating  swelling  of  the  thyroid 
body,  occupying  one  or  both  sides  of  the  larynx.  Treatment : 
Eemoval  of  apparent  causes,  with  good  food,  warm  shelter,  and 
the  administration  of  iodine  or  its  salts.  If  these  are  not  suc- 
cessful, and  if  the  swelling  interfere  with  the  usefulness  or  value 
of  the  patients,  paracentesis  must  be  performed,  and  the  sacs 
afterwards  injected  with  tincture  of  iodine. 

Of  the  compound  or  proliferous  cysts  we  have  examples  in 
cysts  bearing  cysts,  constituting  the  compound  serous  cysts  of 
the  ovaries,  thyroid  body,  and  mammary  gland ;  in  cutaneous 
proliferous  cysts,  or  cysts  bearing  hair  and  skin ;  and  in  denti- 
gerous  or  teeth-bearing  cysts. 

Of  the  cutaneous  cysts  we  have  many  examples  from  the 
horse,  cow,  and  dog.  Hair-bearing  cysts  have  been  found  in 
parts  far  removed  from  the  outer  surface  of  the  body,  as  in  the 
brain  and  ovaries. 

Mr.  Paget  says,  that  "  it  is  perhaps  only  during  the  vigour  of 
the  formative  forces  in  the  foetal  or  earliest  extra-uterine  periods 
of  life  that  cysts  thus  highly  organized  and  productive  are  ever 
formed.  The  sebaceous,  epidermal,  or  ciiticidar  cysts  that  grow  in 
later  life  are  imperfect,  impotent  imitations  of  these,  yet  clearly 
are  the  same  disease,  and  are  therefore  most  naturally  classed 
wdth  the  proliferous  cysts,  needing  only  to  be  named  according 
to  their  contents." 

The  truth  of  the  above  quotation  must  be  apparent  to  all  who 
have  seen  cases  of  this  kind,  for  they  are  generally  found  in 
very  young  animals  as  small  hard  tumours,  some  of  them  having 
a  very  small  aperture  through  which  some  of  their  contents  can 
be  pressed  out,  whilst  the  majority  of  them  are  without  any 
aperture  whatever.  When  cut  into,  they  are  found  to  contain  hair, 
along  with  sebaceous  matter,  forming  a  globular  and  hardened 
mass,  enclosed  in  a  cyst  with  a  laminated  pliable  wall,  lined  with 
epidermis  and  covered  with  hair. 

The  most  important  compound  cystic  diseases  that  come  under 
the  notice  of  the  veterinarian  are — 1st.  That  where  multiple 
cysts,  or  2d.,  dentigerous  cystic  growths,  invade  the  superior 
maxillary  sinuses.  (Photo-lithograph,  Plate  II.,  Pig.  8,  is  an 
illustration  of  the  former,  and  Pig.  9  of  the  latter.) 


444  BENIGN  TUMOURS. 

The  first  form  is  found  in  animals  during  the  active  period 
of  dentition — from  one  to  three  years  old — and  is  recognised 
by  a  gradual  enlargement  of  one  or  both  sides  of  the  face, 
usually  of  one  side  only,  with  a  discharge  from  the  nostril  of 
an  albuminous  fluid  of  the  consistence  of  synovia,  which 
gradually  changes  into  a  purulent  matter  streaked  with  blood. 
There  is  a  snuffling  sound  in  the  breathing,  as  if  the  nasal 
cavity  w^ere  diminished  in  calibre ;  and  this,  as  well  as  the 
swelling  and  discharge,  increases — sometimes  very  rapidly,  at 
other  time  more  slowly,  until  at  last  the  animal  has  to  be 
destroyed. 

There  is  no  cough,  or  if  there  be,  it  is  only  accidental,  and 
the  animal  usually  feeds  well  and  thrives  moderately. 

On  making  a  post-mortem  examination  the  superior  maxillary 
sinus  will  be  found  to  contain  a  rounded  mass  (made  up  of 
numerous  cells,  containing  a  glairy  fluid),  pressing  upon  the 
nasal  borders  and  turbinated  bones,  causing  them  to  bulge  into 
the  nasal  cavity,  diminishing  its  calibre,  producing  a  difficulty  in 
breathing,  and  a  snuffling  sound  during  the  egress  and  ingress  of 
the  air. 

Upon  trephining  a  case  of  this  kind,  it  will  be  discovered  that 
the  sinus  contains  a  glairy  fluid,  and  a  friable  and  highly  vascu- 
lar mass,  which  forms  the  walls  of  the  cysts,  having  a  structure 
similar  to  that  of  the  turbinated  bones.  Whether  it  is  an  extra- 
ordinary development  of  the  sinus  before  the  bones  of  the  face 
are  sufficiently  large  to  accommodate  it,  or  whether  it  is  a  new 
formation — a  cyst — I  can  scarcely  determine ;  but  whatever  it 
may  be,  it  can  be  removed  by  an  operation  if  it  has  not  been 
allowed  to  go  on  too  long.  The  method  of  operation  is  as  fol- 
lows: — Make  an  incision  through  the  skin  about  four  inches 
long,  and  dissect  it  upwards  as  a  flap ;  trephine  the  face,  near 
the  junction  of  the  nasal  and  superior  maxillary  bones  of  the  side 
affected,  in  two  places,  about  three  inches  apart ;  and  with  the 
bone  forceps  remove  the  bone  between  the  two  apertures,  making 
the  gap  about  an  inch  in  width,  then  with  a  hook  and  sharp 
scalpel  dissect  the  whole  of  the  sac  away,  taking  care  not  to 
disturb  the  young  teeth.  If  it  be  found  that  the  turbinated 
bones  have  been  pressed  into  the  nasal  cavity,  a  portion  of  them 
may  be  removed  also.  After  washing  out  the  debris  of  the  sac 
and  clots  of  blood,  bring  the  skin  to  its  proper  position,  and 


TEETH  TUMOURS.  445 

secure  it  by  metallic  suture.  When  the  wound  is  healed,  it  will 
he  found  that  the  discharge  from  the  nose  and  the  difficulty  in 
breathing  have  disappeared,  and  that  the  life  of  a  valuable  young 
animal  has  been  saved. 


DENTIGEROUS  CYSTS  OR  TEETH  TUMOURS. 

Cysts  containing  teeth  have  been  found  in  the  testicles  and 
other  parts  of  the  body ;  but  the  teeth-bearing  cysts,  which  are 
of  importance  to  practical  men,  are  those  immense  collections  of 
imperfect  teeth-forming  tumours  within  the  antrum,  as  shown 
in  Photo-lithograph,  Plate  II.,  Fig.  9.  I  have  met  several  cases 
of  this  kind,  and  have  extracted  teeth  from  even  so  high  as  the 
base  of  the  ear. 

During  life,  these  tumours  are  distinguishable  by  more  or  less 
disfigurement  of  the  face,  by  a  bulging  outwards  of  the  superior 
maxillary  bone,  accompanied  in  some  cases  by  amaurosis  of  one 
eye,  succeeded  by  atrophy  of  the  eye  from  the  pressure  of  the 
growing  tumour.  In  other  cases,  these  complications  are  not 
present,  but  now  and  then  an  abscess  forms  in  the  post-orbital 
region,  which  will  be  found  upon  examination  to  contain  a  hard 
body — an  imperfect  tooth. 

To  understand  the  process  by  which  these  "  teeth  tumours  " 
are  formed,  it  will  be  necessary  to  remember  that  the  teeth  of 
all  animals  belong  to  and  arise  from  the  membraneous  portion 
of  the  digestive  canal,  and  that  at  a  very  early  period  of  foetal 
life  a  provision  is  made  for  the  development  of  the  permanent 
teeth,  as  well  as  for  that  of  the  temporary  ones.  This  provi- 
sion, according  to  Goodsir,  who  devoted  much  attention  to  the 
subject,  is  as  follows : — As  early  as  the  sixth  week  of  intra- 
uteral  life  (in  the  human  foetus)  a  groove  appears  along  the 
border  of  the  future  jaws,  called  the  primitive  dental  groove, 
which  is  lined  by  the  membrane  of  the  mouth.  At  the  bottom 
of  this  groove  projections — ^papillae — spring  up,  corresponding 
in  number  with  the  temporary  teeth ;  these  gradually  increase  in 
size,  and  acquire  the  shape  of  the  future  teeth. 

Whilst  the  growth  of  the  papillae  is  going  on,  partitions  are 
formed  across  the  groove,  by  which  they  become  separated 
from  each  other.  These  partitions  subsequently  form  the  bony 
sockets. 


446 


BENIGN  TUMOURS. 


The  formation  of  these  partitions  places  each  papilla  in  a 
separate  cavity ;  and  concurrent  with  this  process,  small  growths 
take  place  npon  the  membrane  of  the  mouth  just  as  it  dips 
into  the  papillary  cavity  or  follicle,  which  finally,  by  union 
with  other  growths,  form  a  lid  which  covers  the  papillae  in  a 
closed  sac  or  bag. 

Before  the  final  closing  of  the  follicle,  a  slight  folding  inwards 
of  its  lining  membrane  takes  place. 

This  folding  inwards  of  the  membrane  of  the  primitive  groove 
is  for  the  purpose  of  forming  a  new  cavity — the  cavity  of  reserve 
— which  furnishes  a  delicate  mucous  membrane  for  the  future 
formation  of  the  permanent  teeth.  By  consulting  the  diagram 
the  reader  will  better  understand  this  process.     Fig.  1  shows  the 


Fig.  106. 


papilla  standing  in  the  groove,  and  a  slight  folding  inwards  of 
the  membrane  of  the  primitive  groove  near  to  the  lid  on  the 
right  side.  Fig.  2  makes  this  more  apparent ;  and  in  the  other 
Figs,  we  find  the  folded  membrane  considerably  altered  in  form, 
and  increased  in  size,  having  a  projection  from  its  bottom  part, 
— the  papilla  destined  for  the  production  of  the  permanent  tooth 
detached  from  its  follicle. — (From  Simonds  On  the  Age  of  the  Ox, 
&c.,  1854.) 

From  a  study  of  this,  it  will  be  found  that  the  cavity  in 
which  the  permanent  tooth  is  developed  is  a  mere  detachment 
from  the  lining  of  the  primitive  groove,  by  the  formation  of  a 


TEETH  TUMOURS. 


447. 


fold  in  the  lining  membrane,  and  that  in  this  cavity  a  papilla 
is  formed  exactly  in  the  same  way  as  in  that  of  a  temporary 
tooth.  ]^ow,  I  look  upon  the  formation  of  these  dental  tumours 
as  being  due  to  some  eccentricity  in  this  folding  of  the  lining 
membrane,  by  which  the  cavity  of  reserve  is  made  up  of  several 
folds ;  that  these  folds  become  eventually  separated  from  each 
other,  forming  separate  cavities  of  reserve ;  and  that  a  papilla 
becomes  developed  in  each  cavity  tlms  formed  in  a  manner 
similar  to  those  constituting  the  papillae  of  the  natural  teeth. 
These  irregular  papillae  become  finally  converted  into  irregular 
teeth,  which,  for  want  of  space  in  the  mouth,  are  forced  upwards 
into  the  antrum,  and — as  in  the  photo-lithograph — may  com- 
pletely block  it  up,  as  well  as  the  posterior  nasal  opening.  I 
have  classified  them  as  cystic  tumours,  as,  in  the  first  instance 


Fig.  107  and  Diagram,  showing  supposed  development  of  dentigerous  tumour 
A,  Eccentric  folding  of  "cavity  of  reserve,"  3  and  4  showing  its  two  extremities 
2,  the  gum.  B,  Further  development  of  tooth,  and  of  the  eccentric  folding  of  the 
reserve  cavity,  the  folds  becoming  separated  from  each  other,  each  fold  forming  a 
separate  cavity.  C,  shows  two  real  teeth  removed  from  a  tumour  imperfectly 
united,  each  tooth  having  a  pulp  cavity. 

they  are  enclosed  in  sacs  or  cysts ;  they,  however,  soon  "burst 
through  their  investing  membrane,  and  form  a  large  tumour, 
composed  entirely  of  teeth,  having  a  great  variety  of  shapes,  and 
running  in  different  directions.  The  teeth  vary  in  size,  some 
being  very  small,  others  nearly  as  large  as  a  permanent  molar; 
each  tooth  has  a  pulp  cavity,  and  is  composed  of  the  same 
structures  as  the  natural  teeth. 

Should  their  removal  be  determined  upon,  it  will  be  necessary 
to  trephine  the  superior  maxillary  sinus,  and  detach  them  with 
the  forceps. 


CHAPTER  XXTV. 

WOUNDS. 

DEFIN  [TION —  CLASSIFICATION — INCISED — PUNCTURED  —  LACERATED — 

CONTUSED GUNSHOT POISONED TREATMENT    OF   WOUNDS 

SUTU RES COLLODION STYPTIC-COLLOID SHELLAC    PASTE 

NON-INTEREERENCE. 

The  term  wound  sij^niifies  a  recent  solution  of  continuity  of  the 
livini^^  tissues  IihIucimI  l)y  some  ineclianic.iil  cause. 

Wuunds  are  classilied  under  the  following  heads: — Incised, 
jpundurcd,  lacerated,  contused,  gunshot,  and  poisoned. 

The  various  modes  of  healing  are  considered  in  the  following 
order,  namely : — 1.  ]*>y  immediate  union ;  2.  By  primary  ad- 
hesion ;  3.  By  granulation ;  4.  By  secondary  adliesion,  or  the 
union  of  granulations;  5.  By  healing  under  a  scab.  These  five 
modes  are  sometimes  called: — 1.  By  the  hrst  intention;  2.  By 
the  adhesive  inllammation ;  3.  By  the  second  intention;  4.  By 
the  third  intention ;  5.  Subcrustaceous  cicatrisation. 

1.  Incised  wounds. — An  incised  wound  is  that  made  with  a 
clean-cutting  instrument.  The  textures  are  divided  evenly  and 
smoothly ;  there  is  no  tearing  or  bruising  of  parts,  hence  the 
htTcmoiThage  is  at  first  much  greater  than  in  most  other  wounds. 
If  the  wound  has  been  i)arallel  to  the  course  of  the  muscular 
fibres  of  the  part,  there  is  no  gaping  of  the  edges  so  long  as 
the  part  is  lve])t  in  ])osition ;  but  if  the  cut  be  across  the  direc- 
tion of  the  muscular  libres,  or  transverse  to  the  axis  of  a  limb, 
the  wound  will  be  drawn  apart,  the  deep  parts  more  so  than 
the  superficial,  owing  to  the  retraction  of  the  divided  muscular 
fibres,  and  a  cavity  formed  in  which  blood  and  pus  are  apt  to 
collect  and  retard  the  progress  of  repair. 

The  treatment  of  this  sort  of  wound  is  very  simple,  but  it 
comprehends  four  important  indications,  namely — 1.  To  arrest 


INCISKI)  WOUNDS.  440 

hjcmoiTlia«;o ;  2.  To  r('in()V(^  forci^Mi  Ixxlica;  .'{.  To  orfuct  and 
inaiTitairi  co-adjipUiMoii  ;  and  4.  'I\»  ^nuird  jiirainHl  oxc^cHHivo 
infljiniiriiiiioii.  (I.)  n;i'nionliM|^M',  wlicMicr  niiilicial  or  vc.iiouh, 
is  lo  l)(3  {urcHlcd,  jiiid  tliiM  i.s  Mic,  lirMl, Miin^^  UimI,  irniHl,  IxMiMcMidcd 
to.  If  it  ariscH  IVoiri  Ji,  .sin.ill  uvUwj  puvi'mUy  cut,  blood  of  a 
l)ri«;lit  red  colour  (Iowh  or  m|»uiI,m  ouI,  in  jcl-H ;  })ut  if  it  bo  coin- 
])lei(;ly  out  across,  tlic  ends  contriid,,  and  I  Im^  Imriiorrluii^o  ceases. 
In  some  caihv.h  ilie  1)l(',(;dinf^  will  (lontiniK;  nHJion^fh  tlie  n,rt(!ry  be 
divid«'.d  conipleU^ly  jutohh,  or  will  inke  pljice  from  l-inie  l,o  time, 
and  jH'ove  aeiiouH.  Jn  hi:»'1i  inMf,}i,neeH  tlie  end  of  Mi(5  jirtciy  niust 
be  searclied  for,  drawn  oiil  by  Mui  forceps,  and  tied  by  a  li;^at-nr(i ; 
occasionnlly  it  will  be  found  necessary  lo  cnlar^^e  tlie  wound  to 
do  tliin  effeeiiiiiily. 

Venous  bleedin^^  is  generally  ejiHily  nrrested  by  moderate 
])ressure,  or  ])y  an  astringent  ;i,p|)lic.'i,ti()n,  hiicJi  im  a  solution  of 
tlie  tincture  of  tcrrc.hloride  of  ircui.  As  ji,  riih^,  even  tbesc;  sliglit 
a.ppli(5ationfl  are  nnncc-essary,  vciioum  l)le(!(linM;  stoppinj^  spon- 
taneously if  tlic,  wound  is  expOMcd  to  cold  ;iir  ;  but  if  Ji,  largo 
vein  be,  wounded,  it  is  oFtcii  necesssiry  to  tic,  it  witli  ji,  ligjiture. 

When  tlie  bleeding  i.s  Jirrcsted,  nil  clots  of  blood,  dirt,  and 
foi'cign  bodies  are  to  be  removed  IVoni  \.\h\  wound  by  careful 
s[)onging  with  tepid  w;il,er.  In  sponging  u,  wound,  cjire  must 
be  taken  not  to  injure  its  surface;  by  ;i,ny  undue  pressun;.  It 
is  quite  sudicicnit  to  squeeze  the  wiit(a-  out  of  the  sponge  on  to 
the  wound,  without  tla;  sj)ong(i  being  brought  into  conl,!i,ct  with 
it.  This  is  e.-isily  done  by  placing  thc^  sfionge  n,t  a  little  dis- 
tance above  the  wound,  and  jillovving  tin;  w.'iter  to  flow  gently 
over  the  wounded  surfjice.  If  any  materials  ;i,re  lirrnly  im- 
bedded ill  the  tissues,  they  riiiist  be  renioved  by  the  forceps  oi* 
the  point  of  th(}  finger.  ( !le;ining  wounds  with  a,  (coarse  briiHli 
cannot  be  too  highly  condenmed. 

In  wounds  when;  muscular  (ibrcM  are  deeply  cul,  if,  is  recom- 
mended, more  especially  by  Mr.  Syme,  that  the  wound  should 
remain  open  for  a,l)out  ei<dit  hours,  for  the  jiurpose  of  allowing 
the  disci ia.rges  of  blood  and  serum  to  ( escape  ;  or  if  sutunjs  are 
imm(;(liately  em]»loy(;d,  they  should  be  a|)plied  in  such  a  loose 
marincT  as  to  allow  tlu;  blood  and  seroMity  to  escape,  and  all 
clots  which  m.'iy  afterwards  form  washctd  out.  This  is  good 
])ra(;tice,  and  ensures  he-aling  })y  adhesion  in  many  cas(!S  that 
would  otherwise  run  on  to  the  more  tardy  [jroceas  of  granulation. 

20 


450  WOUNDS. 

In  many  large  wounds  sufficient  room  for  the  escape  of  the 
discharges,  which  are  always  profuse  for  the  first  few  hours, 
may  be  obtained  by  omitting  one  or  even  two  sutures  at  the 
most  dependent  part  of  the  wound,  which,  if  it  be  parallel  to 
the  axis  of  the  limb  and  the  direction  of  the  muscular  fibres, 
is  easily  brought  together  and  maintained  so  by  a  few  sutures, 
placed  about  an  inch  apart.  If  the  wound  be  transverse  to  the 
direction  of  the  limb  or  muscular  fibres,  with  a  cavity  formed 
by  the  retraction  of  the  divided  muscular  fibres,  it  is  difficult  to 
bring  its  lips  into  apposition ;  and  even  when  they  are  co- 
adajjted  by  firm  and  strong  sutures,  the  skin  into  which  they 
are  inserted  is  almost  sure  to  slough,  the  process  of  healing 
being  at  the  same  time  retarded  by  the  irritation  set  up,  and 
the  blemish  increased  to  a  considerable  extent.  In  such  cases 
the  best  plan  is  to  bring  the  lips  together  at  their  extremities, 
using  the  quilled  suture,  and  leave  a  gap  at  the  central  portion 
of  the  wound ;  or,  if  the  cavity  be  very  deep  and  in  a  downward 
direction,  it  may  be  necessary  to  make  a  counter-opening  at  its 
inferior  part,  to  allow  the  discharges  to  escape.  If  such  be  the 
case,  the  lips  of  the  original  wound  are  to  be  brought  together, 
and  it  is  possible  they  may  heal  by  the  adhesive  process. 

The  edges  of  wounds  are  kept  in  apposition  by  means  of 
sutures,  pins,  plasters,  and  bandages.  Plasters  are  rarely  used 
in  veterinary  practice,  but  their  employment,  especially  in 
wounds  in  the  lower  portions  of  the  extremities,  may  with 
advantage  be  preferred  to  that  of  sutures,  as  they  cause  no 
blemish.  A  longitudinal  or  even  transverse  wound  situated  on 
a  leg  is  easily  brought  together  by  plasters,  over  which  a 
moderately  firm  bandage  can  be  applied ;  and  a  wound  so 
treated  will  heal  in  less  time,  and  leave  a  smaller  blemish, 
than  when  sutures  are  employed. 

Various  forms  of  sutures  are  employed  for  keeping  the  edges 
of  wounds  together ;  the  interrupted  suture  is,  however,  the  form 
mostly  in  use,  and  the  material  "the  metallic  suture  wire." 
The  wire  causes  less  irritation  than  thread,  and  is  to  be  always 
used  in  preference.  It  can  be  had  in  thickness  and  strength 
adaptable  to  almost  all  wounds,  with  needles  grooved  for  the 
purpose,  from  the  instrument  makers. 

The  twisted  suture,  or  the  pinning  of  wounds,  is  performed 
as  follows : — Having  brought  the  lips  of  the  wound  nearly  into 


INCISED  WOUNDS.  451 

contact,  a  "  pin-director/'  with  the  pin  in  its  concavity,  is  to  be 
introduced  from  the  outside  inwards,  and  carried  out  throujih 
the  opposite  side  to  the  same  distance  from  the  edge  that  it 
entered  on  the  former  side;  the  director  is  then  withdrawn, 
and  the  pin  left  in  and  secured  in  its  position  by  a  firm  wax 
ligature  passed  around  it,  making  the  figure  of  8,  by  which  the 
wounded  parts  are  drawn  gently  into  contact.  The  number 
of  pins  is  to  be  determined  by  the  size  of  the  wound ;  three- 
quarters  of  an  inch  to  one  inch  is  a  proper  distance  between 
two  pins. 

The  Quilled  Suture. — ^TVTien  pressure  is  required  on  the  deep 
as  well  as  the  superficial  parts,  this  form  of  suture  is  employed. 

This  suture  is  best  applied  with  a  strong  curved  needle,  fixed 
in  a  handle,  and  having  an  eye  near  the  point.  This  can  be 
threaded  with  the  loop  of  double  twine,  strong  thread,  or  catgut. 
The  needles  must  pierce  the  skin  not  closer  than  an  inch  from 
the  edge,  deeply  inserted,  and  brought  out  at  the  same  distance 
beyond  the  opposite  margin  of  the  wound.  This  will  leave  a 
double  thread  through  the  wound,  with  a  loop  on  one  side  and 
two  free  ends  on  the  other.  Through  each  loop  so  formed  a 
piece  of  whalebone  or  cane  should  be  passed,  and  the  threads 
firmly  drawn  over  it,  while  the  free  ends  are  firmly  tied  over  a 
similar  piece  on  the  opposite  side  of  the  wound.  To  maintain  a 
more  perfect  apposition  in  the  more  superficial  parts,  a  few  in- 
terrupted sutures  may  be  inserted  to  the  margins  of  the  wound. 

When  an  injury  is  superficial,  sutures  are  not  required ;  and 
in  parts  where  plasters  cannot  be  applied  they  can  be  kept  in 
apposition  by  collodion,  styptic-colloid,  or,  what  is  more  economi- 
cal, a  thick  solution  of  shellac  in  methylated  spirit,  which  may 
be  prepared  and  kept  ready  for  use  in  a  wide-necked  bottle  with 
a  tight-fitting  cork. 

As  to  local  applications  to  incised  wounds,  fortunately  the 
days  are  past  when  greasy  ointments,  friars'-balsam,  black  oils, 
and  other  irritating  abominations  were  made  use  of,  and  now-a- 
days  wounds  are  left  alone.  If  anything  be  done  at  all,  the 
best  application  to  the  surface  of  the  skin  around  the  wound  is 
the  ordinary  white  lotion,  gently  squeezed  out  of  a  sponge,  and 
allowed  to  trickle  over  the  surrounding  skin ;  care  being  taken 
that  the  sutures  are  not  disturbed,  nor  the  dried  discharge 
which  covers  the  surface  of  the  fissure  removed.     Fomentations 


452  WOUNDS. 

with  hot  or  cold  water  are  also  objectionable,  because  they 
increase  the  discharge  from  the  wounded  surfaces,  disturb  the 
sutures,  and  invariably  bring  on  the  suppurative  action. 

If  all  goes  on  well,  the  sutures  are  to  be  carefully  removed  at 
the  end  of  the  fifth  or  sixth  day,  when  it  will  be  found  generally 
that  the  wound  has  fairly  united ;  but  should  the  lips  begin  to 
gape,  the  surrounding  parts  to  inflame,  pus  be  discharged,  the 
sutures  to  drag,  and  cut  the  skin,  some  of  the  sutures  at  least 
must  be  removed,  the  wound  gently  bathed  with  tepid  water, 
and  its  surface  dressed  with  very  dilute  carbolic  acid,  a  solution 
of  iodine,  or  the  latest  antiseptic  dilute  boracic  acid.  In  warm 
weather,  and  in  cases  that  begin  to  inflame,  tow  or  lint  dipped 
in  cold  water  may  be  gently  laid  over  the  wound,  and  retained 
in  position  by  a  light  bandage  placed  at  a  little  distance  from 
the  wound.  This  should  be  occasionally  wetted  with  cold 
water  in  which  carbolic  acid  has  been  dissolved.  It  is,  how- 
ever, better  not  to  interfere  in  any  way,  except  when  absolutely 
necessary. 

Tlie  Constitutional  Treatment. — Prescribe  a  cooling  diet ;  ad- 
minister a  gentle  purgative,  and  order  quietude. 

The  application  of  oiled  silk,  thin  gutta-percha,  or  any  other 
waterproof  covering  to  the  wet  dressings,  is  objectionable  in 
veterinary  practice,  more  especially  in  horse  practice,  as  the 
parts  so  confined  are  apt  to  become  highly  inflamed,  and  the 
skin  blistered. 

2.  Punctured  wounds  are  produced  by  the  penetration  of  a 
sharp  or  blunt  pointed  instrument  into  the  tissue  usually  to  a 
depth  disproportionate  to  the  aperture  of  entrance.  Punctured 
wounds  are  the  most  dangerous  of  all  wounds,  and  for  the 
reasons  that,  from  their  depth,  they  are  liable  to  implicate 
arteries,  nerves,  veins,  viscera,  and  deep-seated  vital  parts; 
that  the  parts  which  they  traverse  are  stretched  and  torn,  and 
consequently  are  disposed  to  inflame  and  suppurate ;  and  pus, 
when  formed,  has  no  free  exit,  and  is  liable  to  burrow  exten- 
sively ;  that  foreign  bodies  may  be  carried  to  great  depths  with- 
out being  suspected,  and  create  long-continued  irritation ;  and 
finally,  punctured  wounds  are  most  liable  to  be  followed  by 
tetanus. 

The  treatment  of  punctured  wounds  must  be  conducted  in 
accordance  with  the  gravity  and  depth  of  the  puncture,  and  the 


PUNCTURED  WOUNDS.  453 

amount  of  laceration  and  contusion.  If  the  wound  be  shallow, 
attended  with  little  or  no  bruising,  and  free  from  foreign  mat- 
ters, adhesion  may  be  possible,  and  ought  to  be  promoted ;  and 
so  long  as  oozing  continues  from  the  orifice,  cold  water  bathing 
is  to  be  practised.  When  no  more  blood  or  serosity  issues,  a 
pledget  of  tow  dipped  in  collodion,  or  the  shellac  solution,  is  to 
be  placed  over  the  opening  so  as  to  cover  it  entirely,  or  with  the 
exception  of  its  most  depending  part. 

The  animal  is  to  be  kept  quiet ;  a  purgative  given,  and  a  mash 
diet  prescribed. 

In  more  serious  cases,  or  in  the  simpler  ones,  when  inflamma- 
tory swelling  supervenes,  the  wound  must  be  dilated  freely. 

In  deep  punctured  wounds,  with  haemorrhage,  it  may  be  neces- 
sary to  dilate  in  order  to  secure  an  artery,  or  to  remove  a  foreign 
body ;  and  in  the  minor  punctures,  often  seen  in  the  neighbour- 
hood of  the  elbow,  it  is  important  to  bear  in  mind  that  there  is 
great  risk  of  sub-fascial  suppuration  if  dilatation  is  not  practised 
early.  If  there  be  much  tension  the  skin  and  subcutaneous  fascia 
are  to  be  divided  longitudinally  and  to  the  same  extent.  Then 
the  fascia  is  to  be  divided  transversely,  so  as  to  make  a  crucial  inci- 
sion in  it ;  this  will  relieve  all  tension.  The  same  rule  applies  to 
partially  divided  muscular  fibres;  they  must  be  divided  thoroughly 
and  completely,  both  by  a  longitudinal  and  a  transverse  inci- 
sion, so  as  to  give  free  vent  to  any  discharges  from  the  deeper 
parts  of  the  wound. 

When  this  is  done,  warm  fomentations  are  to  be  frequently 
and  freely  applied;  and  in  situations  where  poultices  can  be 
adjusted,  they  should  be  employed — (boiled  turnips  form,  1 
think,  the  best  poultice  ;  they  are  very  soft,  and  retain  their 
moisture  for  a  longer  time  than  btan  or  linseed  meal) — and  the 
surface  of  the  wound  dressed  with  white  lotion  or  opium,  and 
water. 

The  constitutional  treatment  must  be  directed  to  relieve  pain 
by  opium,  and  the  accompanying  fever  by  a  purgative,  aconite, 
and  antiphlogistic  diet.  If  the  puncture  be  in  a  foot  or  limb,  with 
excessive  lameness,  and  inability  to  lie  down,  the  slings  must  be 
early  employed. 

Fungous  protrusions  or  excessive  granulations  on  the  surface 
of  the  wound  are  not  to  be  irritated  by  caustic  applications ; 
they  are  the  tissues  of  the  part,  swollen  and  congested,  and  will 


454  WOUNDS. 

disappear  when  the  inflammation  subsides.  If,  however,  after 
the  inflammation  has  been  subdued,  the  exuberant  granulations 
continue  in  the  wound,  they  are  to  be  destroyed,  and  the  tissues 
stimulated  to  healthy  action  by  being  touched  with  the  nitrate 
of  silver.  In  some  instances,  owing  to  debility  of  constitution, 
these  granulations  continue  as  flabby,  pale-looking  excrescences, 
notwithstanding  efforts  to  repress  them,  discharging  a  sero-puru- 
lent  matter.  Their  repression  will  then  be  best  effected  by  atten- 
tion to  the  constitution  of  the  animal,  and  by  repeated  applica- 
tions of  astringents. 

Fungous  granulations  are  very  often  caused  by  injudicious 
bandaging,  and  in  many  instances  where  bandages  have  been 
applied  to  a  woimded  part  they  will  entirely  disappear  upon  the 
discontinuance  of  the  bandages,  and  if  a  wound  from  which 
foreign  bodies  have  been  removed  is  not  irritated  by  bandages, 
undue  interference,  or  what  are  termed  digestive  ointments,  no 
sprouting  of  proud-flesh  will  occur.  There  are,  however,  excep- 
tional cases,  and  it  may  be  necessary  in  these  to  support  the 
vessels  of  the  part,  and  repress  the  granulations,  by  properly 
adjusted  bandages.  Their  effects  are  to  be  closely  watched,  for 
generally  they  irritate  the  wound  and  excite  fungous  growths. 

Sulphate  of  copper,  either  in  solution  or  as  a  fine  powder,  is 
very  generally  applied  to  these  granulations.  I  think  it  is  a 
very  irritating  application,  and  not  so  serviceable  as  the  nitrate 
of  silver.  In  cases  where  the  cause  of  exuberant  granulations 
can  be  traced  to  the  constitution,  tonics,  good  food,  and  pure  air 
are  more  to  be  depended  upon  than  any  mere  local  application. 
"When  the  constitution  of  the  animal  is  good,  and  the  treatment 
proper,  the  cause  of  the  continuance  of  unhealthy  granulations 
generally  depends  upon  the  presence  of  some  foreign  body  in  the 
wound  ;  and  of  this  a  wound  in  the  foot,  pressed  by  a  small  por- 
tion of  horn,  may  be  taken  as  a  famihar  example.  Here  we  find 
that  the  strongest  escharotics  are  powerless  in  suppressing  the 
growth  of  "proud-flesh"  so  long  as  the  horn  is  allowed  to  irri- 
tate by  pressing  unduly  upon  any  part  of  the  wound ;  but  if  the 
obnoxious  piece  of  horn  be  removed,  the  granulations  will  cease 
to  grow ;  and  if  the  part  be  exposed  to  the  air,  will  wither,  scab 
over,  and  heal  in  a  very  short  time. 


CONTUSED  AND  LACERATED  WOUNDS.  455 


CONTUSED  AND  LACERATED  WOUNDS. 

The  division  into  contused  and  lacerated  wounds  may  be 
classified  as  one  of  two  sections,  namely — 1.  Contusion  with 
ecchymosis  ;  and  2.  Contused  and  lacerated  wounds. 

A  contusion  is  an  injury  inflicted  by  some  blunt  object,  with- 
out perforation  of  the  skin,  and  its  consequences  are — (1.)  A 
degree  of  concussion  or  benumbing  which  may  be  severe  without 
further  mischief,  as,  for  example,  when  a  horse  strikes  his  leg 
mth  the  opposite  foot,  goes  lame  for  a  time,  but  very  shortly  is 
all  right  again.  This  is  called  hrushing  or  interfering,  and  a 
repetition  of  it  will  cause  some  structural  change  in  the  part 
contused.  Horses  that  brush  require  to  be  shod  with  a  preven- 
tive shoe,  or  to  wear  a  boot  made  for  the  purpose.  This  infirmity 
is  commonly  seen  in  the  hind  legs,  where  it  is  of  less  conse- 
quence than  in  the  fore  ones.  Horses  that  cut  or  brush  with 
their  fore  legs  are  generally  bad-legged  ones,  with  round  fetlock- 
joints  and  turned-out  toes ;  and  they  should  be  looked  upon  as 
unsound,  for  they  may  be  brought  to  the  ground  at  any  time  if 
the  limb  be  severely  struck.  Indeed,  it  is  a  rare  exception  to 
find  an  animal  of  this  conformation  without  broken  knees,  if  it 
has  done  any  work  at  all. 

The  second  effect  of  contusion  is  a  structural  injury,  varying 
in  degree."  Is^^.  There  may  be  rupture  of  the  smaller  blood- 
vessels, and  infiltration  of  the  blood  into  the  surrounding  tissues, 
constituting  ecchymosis.  2d.  A  large  blood-vessel  may  be  rup- 
tured, and  the  blood  extravasated  in  considerable  quantity, 
tearing  up  the  areolar  tissue  in  which  it  coagulates ;  or  if  an 
artery  be  cut,  a  false  or  diffused  aneurism  may  be  the  result. 

The  third  effect  may  be  the  forination  of  a  serous  abscess. 

The  fourth  effect  may  be  the  pulpification,  disorganization, 
and  subsequent  mortification  of  the  part  contused,  not  merely  of 
its  surface,  but  of  structures  deeply  imbedded  beneath  the  skin. 
Eepeated  contusions  of  the  coronet  and  pastern,  by  "  brushing  " 
or  "  interfering,"  are  succeeded  in  the  colder  months  of  the  year 
by  violent  inflammation  of  the  skin  and  subcutaneous  tissues, 
and  the  formation  of  abscesses  in  the  parts,  which  sometimes 
endanger  the  life  of  the  animal  by  the  severity  of  the  accom- 
panying fever ;  whilst  in  other  cases  the  inflammation  extends 
into  the  joints,  rendering  the  case  almost  hopeless.     The  treat- 


456  WOUNDS. 

ment  of  bruises  or  contusions  is  that  calculated  to  suppress 
inflammation  and  prevent  sloughing.  If  the  bruising  be  very 
great,  there  may  not  be  much  pain  at  the  outset,  and  this  is 
calculated  to  deceive  the  practitioner ;  he  must  therefore  take 
into  consideration  the  character  of  the  accident,  if  it  be  severe 
or  otherwise,  and  the  general  condition  of  the  animal ;  if  there 
be  rigors,  debility,  or  collapse  immediately  after  the  accident,  he 
may  expect  the  reaction  to  be  proportionally  severe. 

The  local  treatment  of  contusions  must  be  directed  to  soothe 
and  prevent  undue  inflammatory  reaction.  For  these  purposes 
warm  fomentations  or  poultices  are  to  be  employed.  The  con- 
stitutional treatment  during  the  stage  of  collapse  must  be  that 
calculated  to  stimulate  and  support,  but  when  reaction  has  set 
in,  the  antiphlogistic  plan  must  be  adopted. 

If  much  blood  is  imprisoned  in  the  tissues,  it  will  be  neces- 
sary to  remove  it;  and  in  those  graver  instances,  where  pulpifi- 
cation  and  sloughing  are  present,  the  process  of  separation  of 
the  dead  tissue  is  to  be  assisted  by  warm  poultices  or  fomen- 
tations, and  putrefaction  confined  to  its  lowest  limits  by  anti- 
septics. 

It  need  scarcely  be  stated  that  excessive  haemorrhage  must 
be  arrested  by  pressure,  or  it  may  be  found  necessary  to  cut 
down  upon  the  vessel,  if  it  be  an  artery,  and  secure  by  ligature. 
During  the  process  of  sloughing,  the  animal  strength  must  be 
supported  by  good  food,  beer,  wine,  quinine,  and  other  tonics. 

Lacerated  Contused  Wounds. — When  the  skin  is  divided, 
lacerated,  and  torn  by  the  contusion,  the  lesion  is  denominated 
a  lacerated  wound.  The  edges  of  such  wounds,  whether  de- 
pending upon  tearing  and  dragging,  or  upon  contusion  and  bruis- 
ing, are  ragged  and  uneven ;  the  parts  being  torn  rather  than 
cut,  and  accompanied  by  much  straining  of  the  surrounding 
tissues.  This  dragging  and  bruising  weaken  the  vitality  of  the 
parts;  this  loss  of  vitality  and  the  depression  of  the  nervous 
system  may  prevent  the  manifestation  of  much  pain  until  reaction 
has  been  established.  There  is  always  less  haemorrhage  than 
from  an  incised  wound,  because  the  vessels  are  irregularly 
divided,  torn,  or  even  twisted. 

The  treatment  of  w^ounds  in  which  laceration  is  the  chief 
characteristic,  or  when  the  contusion  is  slight,  is  that  by  v/hich 
adhesion  is  best  promoted.     Sutures  are  not  generally  applicable, 


CONTUSED  AND  LACERATED  WOUNDS.  457 

co-adaptation  being  best  promoted  by  collodion,  sliellac,  or 
styptic  colloid,  with  absolute  rest  and  cooling  applications,  in 
addition  to  purgative  medicine  and  a  light  diet.  If  inflamma- 
tion and  suppuration  supervene,  the  treatment  must  be  changed 
to  that  calculated  to  promote  the  separation  of  all  sloughs,  and 
the  growth  of  healthy  granulations.  Irrigation  with  warm  water, 
containing  carbolic  acid  or  other  antiseptic,  as  already  recom- 
mended, is  that  best  adapted  for  this  purpose. 


CHAPTER  XXV. 

WOUNDS — continued, 

GUN-SHOT CANNON    BALLS WIND    CONTUSIONS — MUSKET-SHOT  — 

GRAPE-SHOT — SMALL-SHOT — CONSEQUENCES  OF  GUN-SHOT  WOUNDS 

WOUNDS   AND   BRUISES   HAVING   SPECIAL    NAMES SPEEDY-CUT 

TREAD CUTTING    OR    BRUSHING WOUNDS    OF    ABDOMINAL 

PARIETIES — BURNS,  SCALDS,  AND  THE  EFFECTS  OF  COLD POISONED 

WOUNDS. 

GUN-SHOT  WOUNDS. 

Under  this  term  are  included  all  the  injuries  caused  by  the 
discharge  or  bursting  of  fire-arms.  They  consist  of  severe  con- 
tusions, with  or  without  solution  of  continuity. 


CANNON  BALLS. 

The  cannon  ball,  for  the  distance  in  which  its  impetus  and 
velocity  are  greatest,  destroys  everything  that  opposes  its  course. 
If  it  strikes  a  limb,  it  knocks  it  off,  leaving  a  stump  covered 
with  a  disintegrated  mass  of  pulpified  tissues,  and  bone  ground 
down  to  powder.  But  if  the  shot  has  travelled  until  its  impetus 
is  somewhat  lost,  the  injury  it  inflicts  is  ten  times  greater.  It 
tears  its  way  more  deliberately,  lacerates  the  skin,  cuts  the 
muscles  into  longer  and  looser  flaps,  and  splits  the  bones  to  a 
considerable  distance  above  the  wound.  Should  the  shot  strike 
the  limb  slantingly,  it  may  inflict  a  severe  laceration,  with  or 
without  injury  of  the  bone.  Of  such  injuries,  those  which  tear 
across  the  great  vessels  and  nerves  are  the  most  dangerous ; 
Avhilst  lacerations  in  the  length  of  the  limb,  such  as  the  plough- 
ing up  of  the  outside  of  the  thigh  from  hock  to  stifle,  or  from 
stifle  to  hip,  may  be  recovered  from  if  the  great  vessels  be 
untouched. 


GUN-SHOT  WOUNDS.  459 


SPENT  BALLS. 

However  near  to  tlie  end  of  its  career  a  cannon  ball  may 
"be,  it  is  still  a  most  dangerous  thing,  and  many  a  leg  has  been 
knocked  off  by  a  ball  whose  progress  seemed  as  slow  as  that  of 
a  cricket  ball.  But  the  most  important  series  of  injuries  caused 
by  spent  balls  are  the  contusions  which  they  inflict  by  striking 
against  and  rolling  over  parts  after  they  have  lost  the  velocity 
required  for  penetrating  or  carrying  them  away.  Such  injuries 
were  formerly  called  tvind  contusions,  being  supposed  to  depend 
on  the  commotion  of  the  air  caused  by  the  passage  of  a  ball 
close  to  the  part  injured  without  striking  it;  but  now  it  is 
known  that  the  wind  of  a  hall,  though  startling  enough,  has  no 
bad  consequences.  In  many  instances,  although  the  skin  may 
be  intact  or  but  trivially  grazed,  still  the  parts  beneath  have 
been  irretrievably  disorganized,  the  muscles  pulpified,  the  bones 
comminuted,  and  large  vessels  and  nerves  torn  across.  In  less 
severe  cases  there  may  be  enormous  extravasations,  with  or 
without  fracture  of  bone,  followed  by  profuse  and  unhealthy 
suppuration  and  sloughing  of  the  injured  parts. 


MUSKET-SHOT. 

When  a  musket  or  pistol  ball  has  penetrated  the  body,  there 
is  seen  a  hole,  perhaps  rather  smaller  than  the  ball  itself,  with 
its  edge  inverted;  and  if  the  ball  has  passed  completely  through, 
there  will  be  a  larger  and  more  ragged  orifice,  with  its  edge 
everted.  The  oscillations  of  a  musket  ball  are  shown  to  be  in 
the  inverse  ratio  of  its  velocity,  by  its  effects  on  bones.  Thus, 
when  a  ball  propelled  with  great  velocity  strikes  against  a  bone 
of  compact  tissue,  such  as  the  body  of  the  femur,  it  produces  a 
comminuted  fracture  of  the  worst  kind,  shivering  the  bone  into 
splinters,  and  often  splitting  it  up  to  a  great  distance.  But 
when  the  velocity  of  the  ball  is  very  slight,  it  may  be  flattened 
and  rebound ;  or  may,  if  it  strike  a  sharp  edge,  such  as  the  spine 
of  the  tibia,  be  itself  split  into  pieces.  If  it  strike  the  can- 
cellated tissue,  it  will  probably  bore  a  canal  through  it,  of  which 
the  exit  may  possibly  be  twice  as  large  as  the  entrance.  If  the 
propelling  force  be  nearly  exhausted,  the  ball  may  lodge  in  the 
cancellous  tissue,  forming  for  itself  a  kind  of  chamber,  from 


460  WOUNDS. 

which  it  is  with  great  difficulty  extracted  in  consequence  of  the 
small  size  of  the  entrance.  If  the  ball  penetrate  the  cancellous 
tissue  near  a  joint,  it  will  most  probably  shiver  the  bone  between 
its  course  and  the  joint. 

If  it  strike  a  bone  obliquely,  it  may  dig  out  a  longitudinal 
groove  without  fracture. 

A  remarkable  circumstance  connected  with  gun-shot  wounds  is 
the  facility  with  which  the  ball  may  be  diverted  from  its  course 
by  the  slightest  obstacle.  Any  trifling  obliquity  of  surface,  or 
difference  of  density  in  the  parts  which  it  traverses,  may  cause 
it  to  take  a  circuitous  route.  Thus,  a  ball  may  enter  on  one  side 
of  the  head,  chest,  or  abdomen,  and  may  pass  out  at  a  point 
exactly  opposite,  just  as  if  it  had  gone  entirely  through  the 
cavity,  whereas  it  may  be  found  to  have  traversed  the  whole 
way  beneath  the  skin. 

It  is  always  important  to  ascertain  whether  the  shot  has 
passed  out  of  the  body  or  whether  it  has  lodged ;  and  supposing 
there  are  two  holes,  it  must  be  considered  whether  they  are  pro- 
duced by  the  entrance  and  exit  of  one,  or  by  the  entrance  of  two 
distinct  balls.  Sometimes  it  will  happen  that  a  ball  splits,  either 
from  defect  in  the  casting,  or  from  its  striking  against  some  sharp 
bony  ridge ;  and  although  one  portion  may  pass  out,  another  may 
be  lodged  within  the  body. 

It  frequently  happens  that  large  masses  of  metal  are  impacted 
in  the  substance  of  a  part,  without  much  external  indication  of 
their  presence. 

Gun-shot  wounds  may  be  complicated  by  the  presence  of  other 
foreign  bodies  besides  the  ball.  Is^.  Pieces  of  saddlery,  or  of 
the  accoutrements  of  the  horse ;  2d.  Pieces  of  bone  or  muscle 
which  have  become  virtually  extraneous  in  consequence  of  being 
dead  and  detached.  It  must  be  recollected  that  although  there 
may  be  no  ball  in  a  gun  or  pistol,  yet  that  the  wadding  may  act 
as  a  ball,  if  the  piece  is  discharged  close  to  the  animal. 


GRAPE-SHOT, 

Striking  en  masse,  produce  the  effect  of  cannon  balls ;  singly,  of 
musket  balls.  Exploding  shells  cause  fearful  lacerations  and 
contusions ;  and  all  of  these  gun-shot  injuries  may  be  compli- 
cated with  severe  burns  from  the  explosion  of  gunpowder,  with 
imburnt  gunpowder,  and  other  foreign  bodies. 


GUN-SHOT  WOUNDS.  461 


SMALL-SHOT, 

Discharged  from  a  fowling-piece  or  pistol,  produce  different 
effects,  according  to  the  distance  at  which  they  strike.  If  the 
distance  is  great,  they  will,  in  all  probability,  be  scattered  and 
fall  singty,  peppering  the  animal  smartly,  but  not  penetrating 
beyond  the  subcutaneous  tissue,  nor  doing  much  harm,  unless 
the  eyes  be  wounded.  But  if  the  distance  is  small,  so  that 
they  strike  en  masse,  their  effects  are  far  more  destructive  than 
those  of  a  bullet,  for  they  spread  in  the  flesh,  and  so  cause 
great  laceration,  besides  the  mischief  arising  from  their  presence 
in  the  tissues. 


PROGRESS  AND  CONSEQUENCES  OF  GUN-SHOT  WOUNDS  IN 
FAVOURABLE  CASES. 

Inflammation  generally  comes  on  in  from  twelve  to  twenty- 
four  hours  after  a  gun-shot  wound  of  some  common  part.  The 
wound  becomes  swelled,  stif!',  painful,  and  exudes  a  reddish  serum. 
On  the  second  or  third  day  pus  begins  to  be  formed,  but  the 
suppuration  is  limited  by  exudation  of  lymph  around  the  wound. 
About  the  fifth  day  the  parts  in  the  immediate  track  of  the  ball 
which  have  been  killed  by  the  violence  of  the  contusion  begin  to 
separate,  and  change  from  a  blackish-red  to  a  brownish-yellow 
colour ;  and  from  the  ninth  to  the  fifteenth  day  (sooner  or  later) 
the  slough  is  thrown  off.  In  the  meantime  granulations  form, 
the  wound  contracts  and  becomes  impervious  at  the  centre,  and 
heals  up  with  a  depressed  cicatrix. 

In  some  cases,  through  unfavourable  accompanying  circum- 
stances, as  want  of  timely  attention-  improper  applications,  &c., 
the  local  and  constitutional  symptoms  are  much  more  formidable. 
The  pain,  redness,  and  swelling  are  more  severe,  the  wound  dry, 
and  fever  violent.  When  suppuration  is  established,  instead  of 
being  confined  to  the  track  of  the  ball,  it  is  diffused  amongst  the 
neighbouring  muscles  and  under  the  fasciae,  forming  numerous 
and  irregular  sinuses,  so  that  the  case  may  be  in  hand  for  many 
months.  If  the  ball  or  any  other  foreign  body  remain  lodged, 
the  present  inflammation  and  constitutional  disturbance  will  be 
proportionately  severe,  and  the  resulting  suppuration  more  pro- 
fuse and  accompanied  by  more  pain,  till  the  exciting  cause  is 


462  WOUNDS. 

got  rid  of.  But  if  the  constitution  or  the  parts  do  not  possess 
much  irritability,  if  the  ball  be  small  and  polished,  and  if  it  press 
against  no  nerves,  vessels,  or  other  sensitive  parts,  it  may,  and 
often  does,  remain  for  years  without  creating  any  disturbance ; 
a  cyst  being  formed  for  it  in  the  belly  of  a  muscle,  or  the  inter- 
stitial areolar  tissue. 

Mortification  supervening  on  gun-shot  wounds  may  occur 
under  the  following  conditions  : — (1.)  When  the  injured  parts 
are  irrecoverably  disorganized,  so  that  they  immediately  cease 
to  live :  this  sometimes  happens  to  the  tissues  in  the  immediate 
track  of  the  ball,  or  to  a  whole  limb  struck  by  a  spent  ball.  (2.) 
From  excess  of  inflammation  following  a  wound.  (3.)  From 
division  of  the  great  arterial  or  venous  trunks.  This  is  indicated 
by  mortification  in  the  extremity  of  the  limb  ;  the  foot  becomes 
cold  and  insensible ;  this  state  spreads  up  the  limb,  and  the 
parts  immediately  above  those  that  are  actually  dead  become 
slightly  tumefied  and  discoloured ;  and  if  the  animal  is  allowed 
to  live,  the  living  parts  become,  in  the  course  of  two  or  three 
days,  hot,  painful,  and  swollen  to  a  gTeat  extent.  The  constitu- 
tion becomes  affected ;  there  is  restlessness,  anxiety  of  face,  the 
expression  of  the  eye  is  haggard ;  fever  runs  high,  and  the  poor 
animal  sinks,  not  having  sufficient  power  to  throw  off  the  gan- 
gi'ened  part. 

Treatment. — If  the  ball  has  left  the  body,  the  treatment  already 
described  for  contused  and  punctured  wounds  will  be  applicable; 
namely,  for  the  stage  of  collapse,  stimulants,  as  spirits  of  nitre 
or  carbonate  of  ammonia,  and  opium  to  relieve  pain.  If  the 
foreign  body  is  still  in  the  wound  it  should  be  removed  by  in- 
cision, forceps,  or  otherwise ;  but  if  it  cannot  be  removed  without 
a  very  large  incision,  it  had  better  be  left  alone,  as  it  will  be 
brought  within  reach  by  the  contraction  and  granulation  of  the 
parts,  and  by  the  flow  of  pus ;  or  it  may  become  encysted,  and 
give  rise  to  no  further  trouble.  If  a  ball  has  lodged  in  the  sub- 
stance of  a  bone,  it  should  be  removed  by  a  chisel  or  trephine,  or 
necrosis  will  follow. 

Some  wounds  have  peculiar  names,  very  suggestive  sometimes, 
and  very  ridiculous  at  other  times.  Over-reach^  treads,  speedy- 
cuts,  are  bruises  and  contused  wounds. 

An  over-reach  is  a  tread  upon  the  coronet  of  the  fore  foot  from 


SPEEDY-CUT.  463 

the  shoe  of  the  hind  foot.  This  accident  may  occur  from  either 
the  inner  or  outer  side  of  the  toe  of  the  shoe  striking  the  coronet. 

A  tread  is  a  wound  on  the  coronet  produced  by  the  shoe  of 
either  hind  or  fore  foot  upon  the  coronet  of  the  opposite  leg. 

A  speedy-cut  is  a  contusion  on  the  fore  leg,  either  above  or 
below  the  knee-joint.  Horses  subject  to  this  fault  should  be  shod 
very  carefully,  the  shoe  smoothly  filed  on  the  inner  side,  and  the 
clinchers  carefully  attended  to.  I  have  sometimes  seen  horses 
that  required  to  have  their  shoes  removed,  and  their  feet  short- 
ened, at  least  every  three  weeks,  on  this  account.  Speedy-cut 
is  liable  to  cause  a  dangerous  accident,  the  horse  suddenly  falling 
from  the  violence  of  the  pain,  endangering  the  life  of  the  rider, 
and  breaking  his  own  knees.  On  this  account  speedy-cut,  if  it 
cannot  be  prevented  by  shoeing,  may  with  propriety  be  con- 
sidered an  unsoundness. 

Brushing  or  cutting  is  caused  by  the  shoe  of  one  foot  striking 
against  the  fetlock.  Generally  it  is  the  hind  limbs  which  suffer, 
but  not  always.  Young  horses  out  of  condition  often  do  this 
when  they  are  tired  and  exhausted.  They  must  be  shod  with 
preventive  shoes.  In  some  cases  it  is  necessary  to  apply  shoes 
thicker  on  the  inner  than  on  the  outside,  nailed  round  the  toe 
and  outside  only.  But  shoes  thick  on  the  inside  are  to  be  used 
as  seldom  a?  possible,  and  a  three-quarter  shoe,  or  one  thin  on  the 
inside,  without  a  heel  on  the  outside,  is  to  be  tried  in  preference, 
and  for  the  reason  that  when  a  horse  strikes  the  fetlock  with  a 
thick  shoe  the  blow  is  given  with  such  force  as  to  induce  inflam- 
mation and  permanent  thickening  of  the  joint,  with  a  greater 
liability  to  cutting  than  before.  When  horses  have  been  sharp- 
ened during  a  frost  they  are  very  apt  to  tread  themselves,  and 
sometimes  very  severely,  causing  ex^treme  lameness. 


WOUNDS  OF  THE  ABDOMINAL  PARTETES, 

On  account  of  the  structures  which  they  involve,  and  the  danger 
of  intestinal  protrusion,  require  a  speciality  of  management,  more 
particularly  when  situated  in  the  inferior  portion  of  the  abdomi- 
nal walls. 

1st.  Shallow  punctures,  involving  the  muscles,  but  not  pene- 
trating through  the  whole  thickness  of  the  floor  of  the  belly,  are 
very  apt  to  cause  multiple  abscesses.     The  pus  formed  in  the 


464  WOUNDS. 

wound,  being  unable  to  find  exit  on  account  of  tlie  smallness  of 
the  opening,  burrows  between  the  abdominal  fascia  and  muscles, 
separates  them  from  each  other,  causing  pain  and  swelling ;  at 
the  same  time  small  abscesses  form  in  various  parts,  which  are 
difficult  to  heal. 

2d.  Deeper  punctures,  penetrating  almost  or  completely 
through  the  walls,  the  peritoneum  being  divided  or  not  as  the 
case  may  be,  are  apt  to  become  enlarged  by  the  pressure  of  the 
contained  viscera,  and  to  cause  death  by  allowing  the  protrusion 
and  escape  of  the  intestines. 

The  treatment  for  the  first  form  must  be  conducted  with  the 
view  to  allow  the  free  escape  of  pus  and  other  discharges,  and  for 
this  it  may  be  necessary  to  dilate  the  external  opening.  This,  how- 
ever, must  be  done  very  carefully,  or  the  second  danger  may  be 
induced.  Very  often  the  burrowing  of  the  discharges  is  pro- 
moted by  the  drying  of  the  surface  of  the  wound.  This  is  more 
apt  to  prove  injurious  when  the  hair  is  long,  as  the  hair  and  dry 
discharge  become  matted  together  over  the  opening,  which  is  thus 
effectually  plugged  up.  Care  must  be  taken  that  this  does  not 
occur,  and  for  its  prevention  the  hair  must  be  clipped  round  the 
orifice,  and  the  parts  carefully  washed  and  kept  clean.  If  it  is 
necessary  to  dilate  the  opening,  the  incision  should  be  shallow, 
and  along  the  long  axis  of  the  belly.  When  abscesses  form,  it  is 
always  necessary  that  they  should  be  opened  early,  as  the  fascia, 
being  very  tough  and  elastic,  allows  extensive  infiltrations  or 
burrowing  of  the  pus. 

The  deeper  punctures  must  be  treated  with  a  view  to  prevent 
the  escape  of  the  intestines.  The  discharges  from  them  must  be 
allowed  free  exit ;  but  whilst  doing  this,  their  extension  by  the 
weight  of  the  viscera  must  be  prevented,  and  this  may  be  done 
very  effectually  by  enclosing  the  body  of  the  patient  in  a  common 
bed-sheet,  sewn  firmly  round  him.  This  will  form  a  suitable 
support  to  the  weakened  walls,  and  at  the  same  time  allow  the 
escape  of  the  discharges.  Should  it,  however,  become  clogged 
up  by  the  coagulation  of  these,  a  small  hole  may  be  made  in  it 
immediately  below  the  wound. 

When  the  peritoneal  cavity  is  actually  penetrated,  or  even 
when  it  is  only  nearly  so,  the  medical  treatment  should  be  con- 
ducted with  a  view  to  lessen  the  danger  of  peritonitis.  Purga- 
tives are  to  be  witliheld,  and  should  the  pulse  be  at  all  disturbed. 


WOUNDS  OF  THE  ABDOMINAL  PARIETES.  465 

opium  must  be  given,  and  the  large  bowels  unloaded  by  enemas  ; 
fomentations  to  the  belly  are  to  be  persevered  in  until  the 
danger  of  inflammation  is  past. 

Incised  wounds  upon  the  belly,  such  as  those  inflicted  by 
the  tusks  of  a  boar,  an  accident  of  frequent  occurrence,  are 
to  be  treated  by  strong  sutures,  the  collodion  or  shellac  paste, 
and  the  broad-sheet  bandage ;  but  fomentations  are  not  to  be 
applied  as  in  punctiired  wounds,  as  they  would  interfere  with 
the  adhesive  process,  unless,  indeed,  the  danger  of  peritonitis  be 
imminent. 

I  am  clearly  of  opinion  that  purgatives  should  never  be  ad- 
ministered when  the  abdomen  is  wounded,  whether  the  wound 
be  deep  or  shallow,  as  they  may  excite  the  most  dangerous 
complications. 

Wounds  penetrating  the  walls  may  heal  up  externally,  but 
generally  a  hernia  of  greater  or  lesser  magnitude  remains,  form- 
ing a  permanent  blemish. 


BURNS,  SCALDS,  AND  THE  EFFECT  OF  COLD. 

The  first  effect  of  cold  is  to  diminish  the  vital  action  of  the 
part  to  which  it  is  applied.  This  state  of  depression,  when  not 
continued  too  long,  is  succeeded  by  a  more  than  usual  activity, 
or  what  is  called  reaction ;  and  if  this  alternation  be  oft  repeated, 
the  part  becomes  permanently  weakened,  being  slightly  swelled, 
of  a  purple  colour  (as  is  well  shown  in  horses  with  white 
heels),  not  so  warm  as  usual,  and  afterwards  become  inflamed. 
The  skin  will  now  crack,  and  a  discharge  ot  sanguineous  matter 
take  place. 

More  intense  cold  not  only  we9,kens,  but  entirely  suspends 
vital  action.  The  part  becomes  pale,  insensible,  and  shrivelled, 
and  is  said  to  be  frost-bitten.  The  skin,  particularly  the  heel, 
will  often  slough  across  from  side  to  side,  forming  a  strip  of  dead 
skin,  underneath  which  is  a  deep  chasm,  called  a  cracked  heel. 

In  other  instances,  and  particularly  during  long-continued 
snowy  weather,  with  partial  thaws,  succeeded  by  sharp  frosts, 
the  deeper-seated  tissues  of  the  coronet  lose  their  vitality,  and 
deep  and  extensive  sloughs  are  thrown  off,  leaving  the  tendons, 
ligaments,  and  even  the  articulations  exposed.  The  animal  now 
suffers  from  all  the  agonizing  pain,  fever,  emaciation,  &c.,  which 

2  H 


46  &  WOUNDS. 

characterise  open  joint,  and  too  often  succumbs,  or  has  to  be 
destroyed. 

I  had  a  case  in  the  winter  1874-5  where  the  sensitive  frog 
was  frost  or  rather  snow  bitten.  A  piece  about  the  size  of  a 
florin  sloughed  off,  leaving  the  navicular  bursa  opened ;  the 
lameness  was  excessive;  synovia  flowed  abundantly  for  some 
weeks ;  a  large  sinus  formed  in  the  heel.  The  horse,  however, 
fed  moderately  well,  lay  down  and  took  plenty  of  rest,  and  the 
injury  being  in  a  fore  foot — which  makes  a  most  important 
difference  in  all  cases  of  severe  injuries — eventually  recovered. 
The  treatment  consisted  in  the  application  of  poultices,  suc- 
ceeded by  cold  water  and  mild  astringents,  and  finally  blisters 
to  the  coronet,  a  high-heeled  shoe  having  been  put  on  the  foot 
as  soon  as  the  poultices  were  discontinued,  and  which  afforded 
marked  relief.  In  the  treatment  of  frost-bites  poultices  should 
not  be  applied  for  too  long  a  period,  for  after  the  slough  is 
thrown  off  the  parts  recover  quicker  without  than  with  poultices; 
and,  as  a  general  rule,  frost-bites  are  at  first  best  treated  with 
cold  applications;  but  if  sloughing  has  commenced,  poultices, 
irrigations,  or  fomentations  are  to  be  employed,  succeeded  by 
cold  mild  astringents,  antiseptics,  or  deodorizers,  such  as 
charcoal. 

Burns  and  Scalds. — These  are  common  at  iron  works,  and 
result  from  horses  falling  on  hot  dross,  the  bursting  of  steam- 
pipes,  &c. 

The  division  of  burns  is,  from  time  immemorial,  into  three 
classes — (1.)  Burns  producing  mere  redness ;  (2.)  Those  causing 
vesication ;  and  (3.)  Those  causing  death  of  the  part  burnt. 

The  first  class  is  attended  with  mere  superficial  inflammation, 
terminating  with  or  without — more  generally  with — desquama- 
tion of  the  cuticle  and  temporary  loss  of  the  hair. 

The  second  class  is  attended  by  a  higher  degree  of  inflamma- 
tion, causing  the  cutis  to  exude  serum,  and  to  form  vesicles, 
followed  in  most  instances  by  suppuration  and  the  formation  of 
obstinate  ulcers.  The  formation  and  increase  of  these  vesicles 
may  be  often  prevented  by  proper  treatment. 

The  third  class  of  burns  is  attended  with  mortification  from 
disorganization  of  structure ;  the  skin  and  subcutaneous  tissues 
being  literally  roasted  or  boiled,  as  the  case  may  be,  the  blood 
coagulated  in  its  vessels,  and  the  circulation  of  the  part  com- 
pletely stopped.  .     . 


BURNS,  SCALDS,  ETC.  4C7 

In  all  cases  of  severe  scalds  or  burns  there  is  more  or  less  super- 
vening fever,  manifested  by  shiverings,  coldness  of  the  skin  and 
extremities,  prostration  of  strength,  restlessness,  quick  and 
feeble  pulse,  and  heavy  or  sighing  respiration ;  the  surface  of 
the  burnt  part,  if  destroyed,  will  become  pale  and  leathery,  the 
hair  coming  off  in  patches,  leaving  a  denuded  surface,  from 
which  issues  a  thin  serous  discharge.  Swelling  of  the  part 
now  appears,  and  in  about  four  or  five  days  a  line  of  demarca- 
tion surrounds  the  dead  part;  the  chasm  widens,  the  burnt 
portion  contracts  and  dries,  leaving  the  exposed  granulating 
surface  full  in  view ;  the  granulations  are  white,  spongy,  and 
moist ;  there  is  no  discharge  of  laudable  pus,  but  of  a  thinnish 
ichorous  matter,  generally  of  a  dirty- white  colour.  The  slough 
now  falls  off,  leaving  a  wound  of  more  or  less  magnitude, 
according  to  the  severity  of  the  burn,  which  takes  many  months 
to  heal ;  it  then  leaves  a  cicatrix  of  a  hard,  dense,  cartilaginous 
nature,  wliich  contracts  more  or  less,  pulling  the  surrounding 
skin  into  puckered  folds,  which  ever  afterwards  constitute  an 
unsightly  blemish. 

The  most  intractable  cases  are  those  where  the  regions  of  the 
elbow  and  shoulder  are  burnt  or  scalded.  Here,  in  consequence 
of  the  continual  action  of  the  parts,  and  the  attrition  caused  by 
the  motion  of  the  chest  against  the  muscles  of  the  inner  part 
of  the  arm,  the  wound  never  heals.  Very  often  the  whole  limb 
is  burnt,  exposing  tendons,  muscles,  and  destroying  the  tissues 
protecting  the  articular  cavities ;  such  cases  should  always  be 
destroyed  at  once.  But  if  the  gluteal  region  or  thick  part  of  the 
thigh  be  burnt,  involving  none  of  the  joints,  recovery  may  ensue, 
altliough  the  injury  be  excessive. 

Horses  sometimes  die  from  the  first  shock ;  the  animal  sinks 
from  collapse  ;  the  rigors  become  severe,  with  great  restlessness, 
feebleness  of  the  pulse,  sighing  respiration,  rapid  prostration, 
and  death. 

Treatment.— Id.  all  curable  cases,  the  Carron  oil,  namely, 
linseed  oil  and  lime  water,  in  equal  parts,  is  to  be  applied 
frequently.  A  good  plan  is  to  dredge  this  over  with  flour,  or 
if  the  oil  and  lime  water  is  not  to  be  easily  got,  dredging  with 
flour  is  a  good  plan.  The  Carron  oil  and  flour  prevent  pain, 
by  excluding  the  atmosphere;  and  should  neither  remedy  be 
at  hand,  the  parts  may  be  protected  by  cotton  wool  or  anything 


468  WOUNDS. 

that  will  exclude  the  air.  Mr.  Howell  of  Rochdale  recom- 
mends a  solution  of  nitrate  of  silver,  five  grains  to  the  ounce  of 
water,  to  be  applied  continually,  or  as  often  as  each  application 
dries,  for  several  hours.  Opium  and  stimulants  are  to  be 
administered,  and  the  bowels  acted  upon  by  a  purgative.  In 
about  four  days  pus  will  form.  The  wound  has  now  to  be 
treated  like  any  other  suppurating  sore.  If  the  burn  is  slight, 
and  the  structure  of  the  part  merely  inflamed,  the  white  lotion 
is  a  good  application. 


POISONED  WOUNDS. 

Stinging  insects  belong  almost  exclusively  to  the  order  hymen- 
optera,  in  which  the  sting,  in  the  sterile  females,  represents  the 
modified  ovipositor,  and  consists  essentially  of  two  exceedingly 
fine  sharp  darts,  inclosed  in  a  tubular  sheath,  at  the  base  of  which 
is  placed  a  special  venom  sac  or  gland  whose  contents  are  in- 
jected into  the  puncture  by  the  usually  barbed  darts.  The  most 
familiar  examplea  are  the  stings  of  wasps  or  hees.  When  large 
numbers  of  hymenoptera  are  disturbed,  their  attack  may  induce 
severe  or  even  fatal  consequences.  The  bites  should  be  treated 
by  dilute  ammonia. 

The  bites  or  stings  of  insects  cause  a  good  deal  of  irritation 
and  pain  to  animals,  but  are  not  of  much  importance,  and  seldom 
come  under  notice.  Sometimes  the  eyes  become  inflamed,  and 
the  eyelids  swollen  and  painful  from  this  cause.  The  best  pre- 
ventive is  laurel  water,  applied  to  the  parts  twice  a  week. 

Spiders  and  Venomous  Insects. — The  bites  of  several  spiders 
(Araneida)  are  said,  by  various  writers,  to  be  venomous.  Amongst 
these  the  Tarentula  (Lycosa  tarentula),  abounding  in  southern 
Europe,  has  acquired  an  extraordinary  reputation.  Direct  ex- 
periments have,  however,  proved  that  its  bite  is  attended  with 
no  more  ill  consequences  than  a  slight  local  irritation.  In  the 
island  of  Elba  another  species  of  spider  (Aranea  B.  guttata)  is 
reputed  to  be  dangerous  to  men  and  animals,  but  these  reports 
are  doubted  by  various  writers.  Amongst  the  insects  whose 
bites  are  more  than  locally  irritating,  the  tsetse  (Glossina 
niorsitans),  a  dipterous  fly  abounding  in  South  Africa,  and 
described  by  Dr.  Livingstone  in  his  travels.  This  fly  affords  a 
truly  poisonous   matter  of  a   septic  and  diffusive  nature,  by 


POISONED  WOUNDS.  469 

which,  independently  of  any  local  irritation,  the  whole  system 
becomes  fatally  affected. 

The  tsetse  is  a  harmless  looking  insect,  very  little  larger  than 
a  house  fly ;  its  bite  is  innocuous  to  man,  goat,  antelope,  pig, 
ass,  and  all  wild  animals,  and  even  to  the  calf  whilst  sucking ; 
but  fatal  to  the  horse,  domestic  cattle,  sheep,  and  dog.  The 
symptoms  do  not  arise  immediately  after  the  infliction  of  the 
bite,  but  after  an  interval  sometimes  of  several  weeks.  There 
is  then  an  appearance  of  general  disorder,  with  weakness  and 
emaciation  ;  running  at  the  eyes  and  nose,  and  glandular  swell- 
ings under  the  jaws ;  continual  w^asting  of  the  body,  and  finally 
death. 

The  districts  infested  by  the  tsetse  are  very  distinctly  de- 
fined, although  separated  from  a  healthy  one  by  a  narrow  river, 
or  even  an  inperceptible  boundary,  beyond  which  an  animal  is 
never  affected,  unless  it  has  been  into  a  district  infested  by  the 
fly.  It  appears  that  nothing  has  been  ascertained  respecting 
the  nature  of  the  plants  or  vegetation,  or  whether  anything  peculiar 
grows  in  such  districts;  but  travellers  seem  satisfied  that  the  tsetse 
fly  is  never  found  except  where  the  elephant  and  rhinoceros 
abound,  and  that  in  proportion  as  those  animals  are  destroyed 
do  the  ravages  of  the  tsetse  diminish. 

The  Poison  of  Snakes  and  Vipers. — All  the  truly  venomous 
vertebrata  belong  to  the  order  of  ophidian  reptiles,  which  is  sub- 
divided into  two  large  groups  or  sub-orders,  distinguished  from 
each  other  by  clearly  defined  peculiarities  of  organization.  In 
one  of  these  sub-orders,  the  viperina,  the  species  of  which  it  is 
composed  are  all  more  or  less  venomous ;  whilst  in  the  others, 
the  colubrina,  of  which  the  harmless  ringed  snake  of  this 
country  is  an  example,  the  majority  are  innocuous  as  regards 
their  bite,  but  formidable  otherwise :  for  example,  the  boa 
constrictor. 

Characteristics  of  the  venomous  Viperina. — Body  comparatively 
thick  and  clumsy ;  the  general  aspect  sombre  and  lurid ;  and  the 
usual  movements  sluggish  and  dull.  The  tail  is  thick,  and  very 
short ;  the  head  broad,  depressed,  and  triangular,  or  cordiform, 
joined  to  the  trunk  by  a  constricted  neck,  and  covered  on  the 
summit  with  small  scales,  not  plates  or  scutes,  and  having  the 
skin  usually  loose  and  wrinkled ;  the  eyes  are  small,  wholly 
lateral,  deeply  lodged  in  the  sides  of  the  head,  and  shaded  above 


470  WOUNDS. 

Ly  prominent  overhanging  rugose  plates ;  the  pupil  is  elongated 
and  vertical ;  the  upper  lip  descends  on  either  side,  like  that  of 
a  mastiff,  so  as  to  conceal  the  poison-fangs ;  the  scales  are  in 
almost  every  instance  keel-shaped  (carinated),  or  sharp-pointed 
(muricated).  Closer  examination  of  the  internal  structures  of 
the  head  and  oral  organs  will  still  further  disclose  the  more 
decisive  characters  of  the  viperina.  The  maxillary  bones  are 
exceedingly  short  and  mobile,  and  each  supports  a  single  long- 
pointed  and  recurved  tooth,  termed  the  poison  tooth  or  fang, 
perforated  throughout  its  entire  length  by  a  slender  canal. 

By  a  peculiar  arrangement  of  the  maxillary  bones  and  muscles, 
this  tooth,  when  not  in  action,  can  be  reclined  into  a  groove  in  the 
gum,  where  it  lies  completely  concealed ;  but  it  can  be  suddenly 
and  forcibly  erected  when  the  viper  is  preparing  to  strike  its 
deadly  blow.  The  rest  of  the  bones  connected  with  the  jaws, 
face,  and  gullet  are  also  very  loosely  articulated,  and  so  disposed 
as  to  admit  of  enormous  dilatations  of  the  mouth  and  entrance 
into  the  pharynx.  Besides  the  fangs,  the  upper  jaw  contains  no 
teeth ;  but  a  series  of  pointed  recurved  solid  teeth  are  arranged 
along  the  palate.  In  the  lower  jaw  similar  teeth  are  found  at 
the  extremity. 

The  fang  is  traversed  by  a  narrow  canal,  continuous  above, 
with  a  pouch  or  sacculus  surrounding  the  base  of  the  tooth,  into 
which  opens  the  long  curved  duct  of  the  poison  gland.  This 
organ,  wliich,  with  various  modifications,  may  be  described  as 
composed  of  tubular  follicles  communicating  with  a  common 
canal,  has  a  thick  aj^oneurotic  wall  surrounded  by  muscular 
fibres,  in  most  cases  apparently  connected  with  the  temporalis 
muscle,  and  which  are  su]3posed  to  act  as  compressors  of  the 
gland  and  ejaculators  of  its  contents.  The  poison  gland  is 
usually  below  and  a  little  behind  the  orbit ;  but  in  one  remark- 
able instance,  catcsus  rJiombeatus,  it  is  of  an  enormous  size,  and 
situated  on  the  back,  extending  from  the  nape  of  the  neck 
through  nearly  one-sixth  of  the  entire  length  of  the  body,  lying 
immediately  beneath  the  integument,  and  superficial  to  the  ribs 
and  costal  muscles. 

The  venom  of  serpents  when  fresh  is  a  transparent  yellowish 
or  greenish  viscous  neutral  fluid,  very  much  resembling  saliva ; 
insipid  and  almost  inodorous ;  heavier  than  water,  and  not  very 
readily  mixable  with  it;   the  mixture  when  shaken  becoming 


POISONED  WOUNDS.  471 

turbid,  but  exhibiting  no  obvious  characters  denoting  its  virulent 
properties. 

It  contains  besides  albuminous  or  mucous  and  a^small  amount 
of  fatty  matters  and  the  usual  salts,  a  peculiar  principle,  to 
which  Prince  Lucien  Bonaparte  has  given  the  name  of  "  echid- 
nine  "  or  viperine.  It  strongly  resembles  ptyaline,  but  possesses 
active  poisonous  properties  which  are  retained  even  after  it  has 
been  dried  for  a  considerable  time,  if  not  exposed  to  the  air. 

When  the  poison  is  introduced  into  the  stomach,  it  seems  to 
produce  no  effect  beyond  a  temporary  local  irritation ;  nor  does 
it  appear  to  induce  any  deleterious  effect  when  apx-)lied  to  the 
surface  of  the  skin,  even  when  it  has  been  slightly  abraded ;  and, 
according  to  Fontana's  experiments,  it  seems  innocuous  when 
applied  to  the  exposed  surfaces  of  muscular  tissue,  cartilage, 
periosteum,  pericranium,  the  dura  mater,  the  medullary  canal  of 
bones,  cornea,  tongue,  lips,  palate,  exposed  nerves ;  and  all  ex- 
periments tend  to  show  that  in  order  to  produce  its  specific 
effects  it  must  be  directly  introduced  into  the  subcutaneous 
areolar  tissue,  and  even  such  introduction  is  moro  certain  to 
succeed  when  the  poison  is  introduced  through  the  fang  itself 
than  after  inoculation  with  a  cutting  instrument. 

When  introduced,  the  poison  appears  to  cause  death  in  two 
ways ;  when  very  strong,  by  directly  destroying  the  irritability 
of  the  nervous  system,  like  some  of  the  most  powerful  narcotic 
poisons;  when  less  powerful,  by  diffuse  inflammation  of  the 
areolar  tissue,  abscesses,  and  gangrene.  In  the  first-named 
instances  the  symptoms  are  extreme  depression,  and  a  sinking, 
feeble,  flickering,  intermittent  pulse,  coldness  of  the  extremities, 
dilated  pupils,  speedy  insensibility,  stupor,  and  death.  In  the 
second  form,  the  symptoms  are  of  the  most  alarming  asthenic 
character,  from  the  moment  of  the  infliction  of  the  bite,  and  are 
succeeded,  if  the  patient  live  sufficiently  long,  by  diffuse  sup- 
puration and  gangrene.  The  post  mortem  examinations  of  such 
cases  reveal  a  dark,  alkaline,  and  fluid  state  of  the  blood,  which 
emits  a  peculiarly  sickly  odour,  intense  congestion  of  the  lungs 
and  spleen,  with  other  appearances  indicative  of  "  death  of  the 
blood"  (necroemia). 

The  local  treatment  consists  in  preventing  absorption  into  the 
circulation  by  tying  a  ligature  round  the  bitten  limb  upon  the 
cardiac  side  of  the  wound ;  the  immediate  excision  of  the  part, 


472  WOUNDS. 

followed  by  the  application  of  cups  exhausted  of  air  (cupping) ; 
followed  by  the  free  use  of  the  actual  cautery. 

The  constitutional  treatment  must  be  directed  to  combat  de- 
pression by  stimulants — wine,  brandy,  whisky,  or,  according  to 
the  latest  method  practised  in  India,  the  injection  of  ammonia 
into  the  veins.  Other  methods  are  recommended,  such  as  the 
free  use  of  arsenic ;  and  Professor  Bribon's  antidote  finds  favour 
with  some.  It  consists  of  bromine,  five  drachms ;  bichloride  of 
mercury,  two  grains  ;  and  iodide  of  potassium,  four  grains.  This 
is  given  to  the  human  being  in  doses  of  ten  drops,  repeated,  if 
necessar}^,  every  twenty  minutes.  Should  it  ever  be  deemed 
advisable  to  give  this  to  the  horse,  it  must  be  used  in  larger 
doses  than  these ;  care,  however,  being  taken  that  the  bichloride 
is  not  pushed  too  far.  There  are  some  snakes  and  vipers  whose 
bites  are  harmless. 

Animal  poisons,  and  the  poison  of  raMes  that  act  peculiarly 
upon  the  horse,  will  be  considered  upon  another  occasion. 

Sometimes  the  skin  and  subcutaneous  tissues  are  destroyed 
by  the  action  of  some  poisonous  substance,  such  as  the 
mineral  or  other  acids.  I  have  met  with  no  cases  except 
those  caused  by  mineral  acids,  and  the  caustic  alkalies,  which 
have  a  similar  effect  when  accidentally  or  otherwise  applied 
to  the  skin.  These  substances,  when  used  intentionally 
to  remove  morbid  structures,  or  when  applied  to  unhealthy 
wounds,  are  called  caustics.  When  spilled  upon  or  applied  to  a 
large  surface,  their  effects  are  similar  to  those  of  burns ;  they 
inflame  and  afterwards  destroy  the  part.  If  concentrated,  they 
chemically  destroy  the  vitality  of  the  tissues,  and  results  like 
those  supervening  on  burns  are  the  consequence.  If  an  acid 
has  been  the  cause,  it  is  well  to  wash  the  parts  in  some  alkaline 
solution,  to  neutralise  its  effect  as  much  as  possible,  and  to 
destroy  any  that  may  be  left  on  the  surface.  If  a  caustic 
alkali  has  been  the  cause,  a  weak  acidulated  solution  is  to  be 
used,  such  as  vinegar  and  water,  and  the  after  treatment  must 
be  according  to  the  general  principles  laid  down  for  the  treat- 
ment of  burua. 


CHAPTER  XXVI. 

WOUNDS — continued, 

METHODS    OF    REPAIR IMMEDIATE   UNION PRIMARY    ADHESION 

GRANULATION SECONDARY  ADHESION HEALING  UNDER   A  SCAB 

FORMATION  OF  THE  CICATRIX,  AND  COMPLETION  OF  THE  REPARA- 
TIVE PROCESS. 

REPAIR  OF  WOUNDS,  AND  THE  METHODS  OF  HEALING. 

Paget,  in  his  admirable  Lectures  on  Surgical  Pathology,  very 
profoundly  considers  the  question  of  the  reproduction  of  injured 
and  lost  parts;  and  he  says — "  The  ability  to  repair  the 
damages  sustained  by  injury,  and  to  produce  lost  parts,  appears 
to  belong  in  some  measure  to  all  bodies  that  have  definite 
form  and  construction.  It  is  not  an  exclusive  property  of  living 
beings,  for  even  crystals  will  repair  themselves,  when,  after 
pieces  have  been  broken  from  them,  they  are  placed  in  the  same 
conditions  in  which  they  were  first  formed.  The  power  of 
reproduction  is  exemplified  in  a  most  remarkable  manner  in  the 
lower  form  of  animals,  some  having  the  power  of  reproducing 
themselves  from  a  fragment  into  a  whole  and  perfect  body ;  in 
others,  the  reproduction  of  a  lost  limb  has  been  observed ;  but 
in  the  animals  we  have  to  deal  with  this  power  is  limited  to  the 
reproduction  of  tissues  of  three  classes. 

"  1st.  To  those  which  are.  formed  entirely  by  nutritive  repeti- 
tion, such  as  the  blood  and  epithelia. 

"  2d.  To  those  which  are  of  lowest  organization,  and  (which 
seem  of  more  importance)  of  lowest  chemical  characters — the 
gelatinous  tissues,  the  connective,  and  the  bones. 

"  M.  To  those  which  are  inserted  in  other  tissues,  not  as 
essential  to  their  structure,  but  as  accessories,  as  connecting  or 
incorporating  them  with  the  other  structures  of  vegetative  or 
animal  life,  such  as  nerve-fibres  and  blood-vessels. 


474  WOUNDS. 

"  With  these  exceptions,  injuries  or  losses  are  capable  of  no 
more  than  Q^epair,  in  its  most  limited  sense ;  that  is,  in  place 
of  what  is  lost,  some  lowly  organized  tissue  is  formed  which 
fills  up  the  breach,  and  sufi&ces  for  the  maintenance  of  a  less 
perfect  life  of  the  part." 


DIFFERENCES  BETWEEN  THE  HEALING  OF  SUBCUTANEOUS 
AND  OPEN  WOUNDS. 

"  John  Hunter  has  long  ago  shown  that  there  is  a  wide 
difference  between  the  healing  process  in  injuries  which  are 
subcutaneous  and  those  that  open  to  the  air.  He  says — '  The 
injuries  done  to  sound  parts  I  shall  divide  into  two  sorts, 
according  to  the  effects  of  the  accident.  The  first  kind  con- 
sists of  those  in  which  the  injured  parts  do  not  communicate 
externally,  as  concussion  of  the  whole  body,  or  of  particular 
parts — strains,  bruises,  and  simple  fractures.  The  second  con- 
sists of  those  which  have  an  external  opening,  comprehending 
wounds  of  all  kinds  and  compound  fractures.'  He  then  says — 
*  The  injuries  of  the  first  division,  in  which  the  parts  do  not 
communicate  externally,  seldom  inflame ;  while  those  of  the 
second  commonly  both  inflame  and  suppurate.'  It  is  hardly 
possible  to  exaggerate  the  importance  of  the  principle  here  laid 
down,  as  on  it  is  embodied  the  whole  practice  of  subcutaneous 
surgery.  Of  the  two  injuries  inflicted  in  a  wound — namely, 
contusion  and  exposure  to  the  air — exposure  is  the  worse. 
Both  are  apt  to  excite  inflammation,  but  the  exposure  excites 
it  most  certainly,  and  in  the  worst  form — that  is,  in  the  form 
which  delays  the  process  of  repair.  Abimdant  instances  are 
shown  of  this  in  simple  and  compound  fractures,  and  in  the 
injuries  of  articulations.  A  simple  fracture  may  have  been 
caused  by  much  greater  violence  than  the  compound  one,  yet 
the  phenomena  resulting  therefrom  are  not  so  tedious  nor  so 
dangerous  to  life ;  or  a  simple  fracture  extending  into  a  joint, 
even  if  caused  by  great  violence,  is  a  very  different  thing  from 
a  wound  made  into  one,  though  ever  so  gently  made.  We 
have  other  instances  in  the  rarity  of  suppurations,  even  after 
extensive  ecchymoses,  and  the  general  occurrence  of  them  wlien 
wounds  are  left  open. 

"  The  healing  of  open  wounds,  as  already  stated,  may  be 
accomplished  by  five  different  modes. 


METHODS  OF  HEALING.  475 

"  By  what  is  termed  immediate  union  is  meant  that  process 
whereby  the  divided  parts  are  rejoined  without  the  production 
or  the  interposition  of  any  new  material.  Mr.  Hunter  main- 
tained that  union  by  the  first  intention  is  effected  by  means  of 
the  fibrine  of  the  blood  extravasated  between  the  surfaces  of 
the  injured  part,  which  fibrine,  there  coagulating,  adheres  to 
both  the  surfaces,  becomes  organized,  and  forms  a  vascular  bond 
of  union  between  them.  But  it  is  now  admitted  that  he  was 
in  error,  and  that  this  form  of  repair  is  simply  the  restoration 
of  the  parts ;  the  apposition  of  their  surfaces  restoring  the 
vitality  and  circulation. 

"  But  blood  extravasated  in  wounds  is  not  without  its  influ- 
ence on  their  repair,  and  there  are  evidences  to  prove  that 
masses  of  effused,  or  stagnant,  or  coagulated  blood  may  be 
organized.  These  evidences  include  cases  of  blood  effused  in 
serous  sacs,  especially  in  the  arachnoid,  or  clots  in  veins 
organizing  into  fibrous  cords  [as  I  have  seen  in  farcy],  or  clots 
organizing  into  tumours  in  the  heart  and  arteries,  and  the 
clots  so  organized  above  ligatures  on  arteries  as  to  form  part  of 
the  fibrous  cord  by  which  the  obliterated  artery  is  replaced. 
But  there  is  also  evidence  quite  sufficient  to  show  that  extra- 
vasated blood  is  not  at  all  necessary  for  union  by  the  first  in- 
tention, or  for  any  other  mode  of  repair ;  and  the  fact  is  that 
the  repair  is  best,  and  the  material  for  it  most  ample,  where  no 
blood  is  extravasated.  But  though  this  be  the  usual  case,  it 
becomes  a  question — When  blood  is  effused  and  coagulated 
between  wounded  surfaces,  how  are  the  clots  disposed  of  ? 
For  often,  though  not  generally,  such  clots  are  found  in  wounds, 
or  between  the  ends  of  a  broken  bone,  or  a  divided  tendon, 
when  an  artery  by  its  side  is  cut ;  and  in  most  operation- 
wounds  one  sees  blood  left  on  them,  or  flowing  on  their  surface, 
when  they  are  done  up.  How,  then,  is  this  blood  disposed  of  ? 
If  effused  in  large  quantity,  so  as  to  form  a  large  clot,  and 
especially  if  so  effused  in  a  wound  which  is  not  perfectly 
excluded  from  the  air,  or  if  effused  even  in  a  subcutaneous 
injury,  this  blood  is  most  likely  to  excite  inflammation ;  and 
the  swelling  of  the  wounded  parts,  or  their  commencing 
suppuration,  will  push  it  out  of  the  wounds ;  or,  in  more 
favourable  cases,  the  blood  may  be  absorbed,  and  this  may 
happen  when  it  has   formed   separate   clots,   or  more  readily 


476  WOUNDS. 

when  it  is  infiltrated  into  the  tissues.  The  absorption  of 
blood  is  a  very  slow  process,  and  takes  as  much  time  as  the 
healing  of  a  fracture ;  it  is  therefore  the  best  plan,  always  in 
cases  of  punctures  with  small  openings  to  enlarge  the  orifices 
and  remove  the  clot,  if  not  very  deep  seated.  The  best  time 
for  doing  this  is  about  the  third  day  after  the  infliction  of  the 
injury,  as  by  that  time  there  is  not  much  danger  of  secondary 
haemorrhage,  the  mouths  of  the  wounded  vessels  being  sealed 
by  exudation.  But  if  the  blood  is  left  in  a  wound,  its  absorp- 
tion seems  to  be  thus — that  it  is  enclosed  within  the  repara- 
tive material,  and  absorbed  by  the  vessels  of  that  material  as  its 
organization  proceeds.  In  conclusion,  extravasated  blood  is — 
1st.  Neither  necessary  nor  advantageous  to  any  mode  of  healing; 
2d.  A  large  clot  at  all  exposed  to  the  air  irritates  and  is  ejected ; 
Sd.  In  more  favourable  conditions  the  effused  blood  becomes 
enclosed  in  the  accumulated  reparative  material,  and  while  this 
is  organizing,  the  blood  is  absorbed ;  and  lastly,  it  is  probable 
that  the  blood  may  be  organized  and  form  part  of  the  repara- 
tive material ;  but  even  in  this  case  it  probably  retards  the  healing 
of  the  injury." — (Paget's  Surgical  Pathology.) 


IMMEDIATE  UNION. 

The  observations  of  Paget  and  other  modern  surgical  investi- 
gators being  conclusive  that  the  fibrine  of  extravasated  blood 
plays  no  essential  part  in  the  process  of  healing,  it  will  now  be 
necessary  to  follow  the  same  observers  into  the  various  modes 
by  which  repair  is  effected. 

1st.  Immediate  union  is  effected  in  some  cases  of  incised 
wounds  that  admit  of  being  with  safety  and  propriety  closely 
and  immediately  bound  together ;  the  blood,  if  any  be  shed,  is 
thus  pressed  out,  and  the  divided  blood-vessels  and  nerves  are 
brought  into  perfect  contact,  and  union  may  take  place  in  a  few 
hours ;  and  as  no  intermediate  substance  exists  in  a  wound  so 
healed,  no  mark  or  cicatrix  is  left  behind.— (Macartney's 
Treatise  on  Inflammation.) 

In  order  that  this  process  may  be  fulfilled,  it  is  necessary 
that  the  parts  be  in  perfect  contact,  and  in  complete  repose, 
and  that  means  be  taken  to  prevent  the  occurrence  of  inflam- 
mation. 


METHODS  OF  HEALING.  477 

The  second  mode  oj  repair  is  that  hy  primary  adhesion,  or  as 
it  used  formerly  to  be  called,  by  the  "  adhesive  inflammation," 
and  is  thus  accomplished : — When  the  divided  parts  are  allowed 
to  remain  till  the  mouths  of  the  divided  vessels  are  entirely 
shut,  inflammation  inevitably  follows,  and  will  furnish  the 
materials  for  union  by  throwing  out  coagulable  lymph ;  this  is 
called  the  adhesive  inflammation.  The  lymph  is  simply  laid 
on  the  cut  surfaces,  and  scarcely  any  is  infiltrated  into  the 
tissues ;  becoming  organized  and  vascular,  it  connects  the  two 
cut  edges,  aud  finally  forms  between  them  a  thin  layer  of 
connective  tissue,  on  the  surface  of  which,  if  it  be  exposed, 
a  very  delicate  layer  of  cuticle  is  developed.  The  smooth 
shining  surface  of  this  cuticle  gives  the  peculiar  character  to 
the  scar. 

It  was  thought  until  very  recently  that  the  lymph  exuded 
during  the  earlier  stages  of  this  process  developed  itself  into 
the  tissue  by  which  the  repair  was  effected,  but  this  view  is 
incompatible  with  the  opinions  held  at  the  present  time ;  and 
it  will  be  seen  by  reference  to  the  chapter  on  Inflammation 
that  the  formation  of  the  new  connective  tissue  is  effected  by 
the  cells  of  the  tissues  of  the  part  in  which  the  inflammatory 
process  occurs,  and  not  by  the  organization  of  exuded  lymph, 
which  plays  a  passive  rather  than  an  active  part  in  the  process 
of  repair. 

Union  by  primary  adhesion  may  be  accomplished  in  a  very 
short  time.  Sir  James  Paget  mentions  several  instances  where 
the  repair  has  been  thus  effected  in  as  short  a  time  as  seven- 
teen hours. 


HEALING  BY  GRANULATIONS. 

Wlien  a  wound  fails  to  heal  by  either  of  the  two  processes 
already  described,  a  series  of  changes  take  place  in  it  which 
are  termed  healing  by  granulations ;  and  the  simplest  case  for 
illustration  is  that  of  an  open,  gaping  wound,  which  from  the 
time  of  its  infliction  is  only  covered  with  water-dressing.  The 
process  is  as  follows : — Blood  gradually  ceases  to  flow  from  the 
surface  of  such  a  wound;  one  may,  however,  still  see  some 
blood-tinged,  serous-looking  fluid  oozing  from  it.  Slowly,  as 
this  becomes  paler,  some  of  it  collects,  like  a  whitish  film  or 


478  '        WOUNDS. 

glazing,  on  the  surface ;  and  this,  if  examined  with  the  micro- 
scope, will  be  found  to  contain  an  abundance  of  corpuscles, 
having  the  appearance  of  the  white  corpuscles  of  the  blood 
imbedded  in  a  fibrinous  film.  The  collection  of  these  corpuscles 
on  the  surface  of  a  wound,  especially  on  wounded  muscles  and 
fascisB,  appears  to  depend  on  the  peculiar  adhesiveness  which 
they  exhibit  as  soon  as  they  are  removed  from  the  canal  of 
the  healthy  blood-vessel.  The  film  increases  slowly,  and  makes 
the  surface  of  the  wound  look  as  if  covered  wdth  a  thin 
greyish  or  yellowish-white  layer  of  buffy  coat.  This  increase 
of  glazing  is  the  prelude  to  the  formation  of  granulations;  but 
while  it  is  going  on,  and  often  for  some  days  later,  there  is  in 
and  about  the  wound  an  appearance  of  inaction — a  calm  in 
which  scarcely  anything  appears  except  a  slight  oozing  of  serous 
fluid  from  the  wound.  These  periods  of  repose  after  severe  injury 
may  be  the  brooding  time  of  either  good  or  evil;  whilst  it 
lasts,  the  mode  of  union  of  the  wound  will  in  many  cases  be 
determined ;  the  healing  may  be  perfected,  or  a  slow,  uncertain 
process  of  repair  may  be  just  begun.  Immediately  after  the 
infliction  of  an  injury,  and  during  this  period  of  calm,  the 
blood  in  the  adjacent  parts  remains  stagnant.  During  this 
stagnation  materials  may  ooze  from  the  vessels,  enough  to  form 
the  glazing  of  the  wounded  surfaces  of  certain  parts ;  but  before 
granulations  can  be  formed  the  flow  of  blood  must  again  begin, 
and  its  supply  must  be  increased.  So  it  may  be  stated  generally 
that  the  first  visible  change  which  ensues  after  the  period  of  calm 
— the  period  of  incubation,  as  it  is  called — is  an  increased  supply 
of  blood  to  the  parts  in  which  repair  is  to  ensue. 

That  which  next  follows,  after  the  increased  afflux  of  blood, 
is  the  production  of  the  material  to  be  organized  into  granula- 
tions. This  is  added  to,  or  perhaps  displaces,  the  glazing 
already  existing  upon  some  surfaces ;  and  where  none  exists,  as 
on  fat  or  bone,  the  new  material  is  accumulated  on  the  bare 
surface  of  the  wound.  Upon  this  process  it  has  been  remarked 
by  John  Hunter  that  a  white  substance  is  one  day  seen, 
exactly  similar  in  every  respect  to  coagulable  lymph  ;  upon  the 
next  day  this  substance  has  been  found  to  contain  blood-vessels 
(to  be  vascular).  This  is  granulation  without  suppuration,  but 
it  is  very  rarely  observed. 

The  further  development  of  the  reparative  material  is  very 


METHODS  OF  HEALING. 


479 


interesting,  and  a  recently  formed  granulation,  when  examined 
with  the  microscope,  will  be  seen  to  be  composed  of  numerous 
cells  heaped  together  without  apparent  arrangement,  and  con- 
nected by  very  little  intermediate  substance  (protoplasm).  Some 
are  round,  others  caudate,  spindle-shaped,  elongated,  or  splitting 
into  fibres.  Singly,  they  are  colourless,  but  in  clusters  they  are 
ruddy — even  independent  of  the  blood-vessels.  As  the  cells 
become  developed  into  fibres  in  the  deep  layers  of  the  exudation, 
the  superficial  ones,  arrested  in  their  development,  become  con- 
verted into  pus  cells,  which,  after  having  served  to  protect  the 
deeper  seated  and  more  permanent  ones,  are  thrown  off  in  the 
discharge. 


"^o, 


Fig.  108. — Vertical  section  of  a  granulating  sore.  Externally,  pus 
corpuscles  ;  deeper,  fibre  cells  in  various  stages  of  development  into 
fibres.  The  looped  blood-vessels  are  seen  enlarged  at  their  ex- 
tremities. Magnified  100  diameters  linear.  On  the  left  the  cells  are 
magnified  200  diameters  linear. — (Bennett.) 

The  connective  tissue  thus  constructed  by  the  development 
of  the  cells  gradually  assumes  the  characters  of  that  tissue,  and 
as  it  becomes  more  consistent  and  dense,  the  discharge  of  pus 
diminishes ;  a  new  surface  is  produced,  which  after  a  time 
contracts,  and  a  permanent  cicatrix  is  formed.  After  a  time 
yellow  elastic  tissue  is  developed,  and  becomes  mingled  with  the 
white  fibres  of  the  scar. 

Granulations  are  sometimes  arrested  in  their  development 
from  some  unknown  causes,  as  in  indolent  wounds  and  ulcers. 
In  these  cases,  as  is  sometimes  seen  on  the  legs  and  backs  of 
horses,  months  may  pass  and  the  cells  will  not  develop  them- 


480  WOUNDS. 

selves  beyond  one  or  other  of  their  lower  forms.  In  other 
cases,  the  cells  not  only  do  not  develop  themselves,  but  they 
degenerate,  becoming  merely  granular,  losing  the  well-marked 
character  of  their  nuclei,  and  acquiring  all  the  structure  of  the 
pus  cell ;  thus  they  are  found  in  the  walls  of  fistulse  and 
sinuses.  Or,  more  than  this,  the  granulation  cells  may  lose  all 
structure,  and  degenerate  into  a  mere  mass  of  debris  and 
molecular  substance.  They  are  so .  found  on  the  surface  of  a 
wound  a  day  or  two  before  death  from  exhaustion,  as  in  fatal 
cases  of  punctured  foot ;  and  in  this  state  they  are  found,  and 
are  commonly  ejected  when  a  granulating  wound  ulcerates  or 
sloughs.  "With  more  active  disease  they  become  tinged  with 
blood,  or  oedematous ;  such  are  the  spongy  masses  that  protrude 
under  the  name  of  proud-flesh  or  fungus  in  wounds,  and  in 
that  disease  of  the  foot  termed  canker.  "  All  these  are 
hindrances  to  healing;  these  are  the  dangers  to  which  the 
healing  by  granulations  is  obnoxious;  it  is  the  proneness  to 
these  things  that  makes  it  even  slower  and  more  insecure  than 
in  its  proper  course  it  might  be." — (Paget.) 

The  treatment  for  granulation  is  that  calculated  to  repress 
undue  inflammation,  in  fulfilment  of  which  all  sources  of  irrita- 
tion must  be  removed.  Sutures,  if  present,  should  be  removed, 
warm  Avater  dressings  or  irrigations  applied,  cleanliness  en- 
joined, and  to  prevent  putrescence  and  foetor,  weak  carbolic  acid 
or  other  antiseptics.  If  the  discharge  be  excessive,  weak  astrin- 
gents, as  the  white  lotion,  are  useful  adjuncts ;  and  lastly,  it 
must  be  remembered  that  all  pieces  of  pulpified  tissues,  lacerated 
ligaments,  thecae,  or  skin,  ought  to  be  clipped  off,  and  partially 
divided  nerves  cut  across,  and  the  torn  portions  taken  away. 
Without  these  precautions  sloughing  ensues,  and  the  process  of 
repair  will  be  greatly  retarded. 


HEALING  BY  SECONDARY  ADHESION,  OR  UNION  OF 
GRANULATIONS, 

Occurs  when  even  surfaces  of  granulations,  well  developed,  but 
not  covered  with  cuticle,  are  brought  into  contact,  and  so  re- 
tained at  rest.  As  often  as  this  happens,  the  cells  of  which  the 
surfaces  are  composed  adhere  together;  vessels  are  developed 
which  pass  through  them,  forming  mutual  communications,  and 


METHODS  OF  HEALING.  481 

the  surfaces  before  separate  are  united.  Out  of  the  two  layers 
of  granulations  one  is  formed  which  pursues  the  normal  develop- 
ment of  connective  tissue.  Tliere  are  several  circumstances  in 
which  healing  by  secondary  adhesion  should  be  attempted ;  for 
example,  in  a  wound  presenting  two  separate  surfaces,  with  a 
gap  between  them,  where  pressure  can  be  applied  and  the  sur- 
faces brought  into  immediate  contact  or  apposition,  by  bandag- 
ing or  otherwise :  this  may  be  done  in  wounds  of  the  legs,  of 
the  lips,  and  of  the  flank.  In  this  way  wounds  will  heal  up  in 
a  very  short  time,  whereas,  if  they  are  left  to  "  fill  up  "  with 
granulations,  the  process  will  occupy  a  much  longer  period.  In 
applying  means  to  produce  this  method  of  healing,  certain  con- 
ditions are  essential  to  success.  Is^.  That  the  granulations  are 
healthy,  not  inflamed,  profusely  suppurating  or  degenerated,  as 
those  in  sinuses  commonly  are.  2d.  The  contact  between  them 
should  be  firmly  but  gently  maintained. 


HEALING  UNDER  A  SCAB. 

This  method  of  healing  wounds  is  the  natural  one,  and  as 
such  requires  no  art.  It  is  the  method  in  which  nearly  all 
wounds  in  animals,  when  not  interfered  with,  heal.  The  scab 
is  formed  of  the  fluids  that  ooze  from  their  surfaces,  dust  and 
other  foreign  bodie»s  are  entangled  in  this  fluid,  and  under  such 
a  scab  the  scar  or  cicatrix  is  securely  formed.  The  edges  of 
this  scab  adhere  over  those  of  the  wound,  so  as  to  form  for  it  a 
sort  of  air-tight  covering,  under  which  it  heals  without  suppura- 
tion, with  the  formation  of  a  scar,  which  is  more  nearly  like 
the  natural  parts  than  any  scar  formed  in  a  wound  that  remains 
exposed  to  the  air,  and  which  does  not,  like  it,  contract  so  as 
to  produce  deformity  of  the  parts  about  it.  The  scab  may  be 
formed  of  either  dried  blood,  dried  lymph  and  serum,  or  dried 
purulent  matter. 

The  healing  of  a  wound  under  a  scab  has  always  been  consi- 
dered a  desirable  process  ;  but  to  its  universal  adoption  there  is 
some  hindrance.  For  example,  when  the  scab  is  once  formed 
and  the  wound  covered,  it  is  necessary  that  no  morbid  secretion 
take  place.  Whenever,  therefore,  inflammation  ensues  in  a  wound 
covered  with  a  scab,  the  exuded  fluid  collecting  under  the  scab 
produces  pain,  compresses  the  wounded  surface,  or  forces  off  the 

2i 


482  WOUNDS. 

scab.  To  avoid  these  unfavourable  concomitants,  perfect  rest 
must  be  enjoined,  non-interference,  and  a  cooling  diet.  Collodion 
makes  a  good  artificial  scab. 

Such,  tlien,  are  the  several  methods  of  healing  observed  after 
wounds  of  the  soft  parts,  and  in  connection  with  them  we  have 
the  perfecting  of  scars.     In  the  perfection  of  scars  two  things 
may  be  observed,  namely,  their  contraction,  and  the  gradual 
perfecting  of  their  tissues.     A  process  of  contraction  is  always 
associated  with  the  development  of  granulations,  and  this  is  illus- 
trated by  the  smallness  of  the  scar  in  comparison  with  the  original 
wound.     This  contraction  of  both  the  granulation  and  the  scars 
is  regarded  as  some  vital  power  of  contraction,  and  of  a  necessary 
mechanical  effect  of  the  changes  of  form  and  construction  that 
the  parts  undergo.     The  same  change  ensues  in  the  organization 
of  inflammatory  products,  as  in  false  membranes,  indurations, 
and  thickening  of  parts.     In  all  these  cases  the  form  of  the  cell, 
while  elongating,  as  before  described,  into  a  fusiform  body,  is  so 
changed  that  it  will  occupy  less  space.     The  whole  mass  of  the 
developing  cells  becomes  more  closely  packed,  and  the  tissue 
they  form  becomes  much  drier ;  with  this,  also,  there  is  a  diminu- 
tion of  vascularity.     Thus,  there  results  a  considerable  decrease 
of  bulk  in  the  new  tissue  as  it  develops  itself;  and  this  decrease, 
beginning  with  the  development  of  the  granulation  ceUs,  con- 
tinues in  the  scar.      The  improvement  and  perfecting  of  the 
tissue  of  the  scar  is  again  a  very  slow  process.     The  principal 
changes  by  which  it  is  accomplished  include  the  removal  of 
rudimental  textures,  the  formation  of  elastic  tissue,  the  improve- 
ment of  the  fibrous  or  fibro-cellular  tissue,  and  of  the  new  cuticle, 
till  they  are  almost  like  those  of  the  natural  formation — except- 
ing always  that  the  true  skin  is  not  reproduced  with  its  hair 
follicles,  &c. — and  the  gradual  loosening  of  the  scar,  so  that  it 
may  move  easily  on  the  adjacent  parts.     The  tissue  of  the  scar 
extends  dow^n  deej)  into  the  wound,  fastening  itself  immoveably 
upon  its  surface ;  but  after  a  time  it  becomes  more  elastic  and 
looser,  and  the  morbid  adhesions  are  freed.    Thus  we  see  injuries 
to  the  joints  followed  by  much  stiffness ;  this  stiffness — dej^nd- 
ing  upon  the  adhesion  of  the  scar  to  the  deeper-seated  parts — 
gradually  disappears,  and  the  scar  itself  becomes  more  and  more 
pliant,  but  it  never  assumes  the  exact  characters  of  the  original 
tissue,  and  a  scar  remains  a  scar  throughout  the  animal's  life. 


METHODS  OF  HEALING.  483 

All  the  changes  taking  place  in  the  various  methods  of  healing 
of  wounds  occur  in,  and  are  visible  illustrations  of,  the  changes 
that  take  place  in  recovery  from  disease.  In  all  there  is  a 
gradual  approach  of  the  new  particles — which  are  successively 
produced — to  a  nearer  conformity  with  the  specific  character  of 
the  parts  they  should  replace,  till  repair  becomes  almost  repro- 
duction. 

For  an  explanation  of  the  process  by  which  blood-vessels  are 
formed  in  reparative  material,  the  reader  is  referred  to  the 
chapter  on  Inflammation. 


CHAPTER  XXVII. 

RESULTS  OF  WOUNDS. 

ERYSIPELAS,  SIMPLE   AND    PHLEGMONOUS SYMPTOMS  AND  TREATMENT 

TETANUS — IDIOPATHIC    AND    TRAUMATIC VARIOUS    FORMS    OF 

SYMPTOMS PATHOLOGY TREATMENT. 

The  various  forms  of  wounds  having  been  described,  the  dis- 
eases which  occasionally  follow  them  may  here  with  propriety 
be  considered.     These  are  Erysipelas  and  Tetanus. 

ERYSIPELAS. 

Although  the  redness  of  skin,  which  is  one  of  the  charac- 
teristics of  this  disease  in  man,  so  that  it  is  popularly  known 
as  "  the  rose,"  and  "  St.  Anthony's  fire,"  is  absent,  or  at  least 
cannot  be  perceived,  in  the  lower  animals,  owing  to  the  thick- 
ness of  the  epidermis  and  colour  of  the  hair,  yet  it  is  essentially 
the  same,  arises  from  similar  causes,  and  requires  a  correspond- 
ing treatment.  The  disease  in  man  is  divided  into  simple, 
phlegmonous,  bilious,  cedematous,  erratic,  and  periodic ;  but 
in  the  horse  the  cedematous  and  phlegmonous  are  the  only 
forms  originating  traumatically,  and  a  bilious,  periodic  form, 
simulating  what  has  been  already  described  as  lymphangitis 
or  inflammatory  oedema. 

Erysipelas  may  be  defined  to  be  inflammation  of  the  skin 
and  subcutaneous  areolar  tissue,  characterised  by  a  diffused 
swelling  of  the  parts  affected,  which  has  a  remarkable  tendency 
to  spread,  and  is  dependent  upon  some  unascertained  alteration 
in  the  blood 

(EDEMATOUS  ERYSIPELAS. 

This  is  the  most  common  form  of  traumatic  erysipelas  met 


CEDEMATOUS  ERYSIPELAS.  485 

with,  and  generally  succeeds  wounds  of  the  extremities  in 
horses  debilitated  by  hard  work,  bad  keep,  and  in  young 
plethoric  animals,  or  in  those  whose  constitutions  are  tainted 
by  the  poison  of  glanders  or  animal  malaria. 

Si/mjytoms. — In  an  indefinite  period,  but  generally  about 
the  third  or  fourth  day  after  the  infliction  of  an  injury — more 
particularly  if  such  be  on  a  depending  })art  of  the  body — the 
skin  in  the  immediate  neighbourhood  of  the  wound  is  found 
swollen,  smooth,  shining,  hot,  tender,  and  painful ;  the  swelling 
gradually  extends  from  the  wound,  embracing  in  some  instances 
the  whole  superficies  of  a  limb  in  the  course  of  a  few  hours. 
The  swollen  surface  pits  on  pressure  where  much  areolar  tissue 
is  found,  but  where  the  subcutaneous  tissues  are  hard  and  firm, 
the  impression  of  the  finger  is  not  so  well  defined. 

Vesication  sometimes  occurs,  but  this  is  not  a  constant 
symptom,  and  is  succeeded  by  some  amount  of  desquamation, 
more  particularly  at  the  flexures  of  the  joints.  The  local 
.  manifestation  of  the  erysipelatous  inflammation  is  accompanied 
by  some  degree  of  constitutional  disturbance ;  the  pulse  becomes 
quick,  rigors  are  present ;  the  animal  is  "  fevered,"  as  it  is  com- 
monly expressed,  loses  its  appetite,  and  pain  is  manifested  by 
lameness  if  the  disease  be  in  a  limb. 


PHLEGMONOUS  ERYSIPELAS. 

This  is  a  much  more  violent  form  than  the  cedematous,  and 
is  expressed  by  a  great  amount  of  constitutional  disturbance, 
partaking  of  a  typhoid  character ;  the  tendons  and  ligamentous 
structures,  the  fascia  of  adjacent  muscles,  as  well  as  the  skin 
and  subcutaneous  areolar  tissue,  become  involved  in  the  inflam- 
mation ;  the  pain  is  excessive,  the  swelling  is  hard,  tense,  and 
occupies  a  large  extent  of  surface.  In  a  variable  period, 
purulent  collections  form  in  the  subcutaneous  areolar  tissue,  or 
more  deeply  between  the  tendons,  ligaments,  and  fascise,  which 
on  being  opened  discharge  a  watery  pus,  which  may  be  mixed 
with  shreds,  or,  in  more  aggravated  cases,  with  masses  of 
gangrenous  tissue.  The  systemic  disturbance  is  severe ;  rigors 
are  frequent;  pain  is  acutely  felt;  the  pulse  becomes  small, 
quick,  and  feeble ;  the  respirations  hurried  ;  the  bowels  generally 
constipated,  the   fteces    covered   with   mucus,   and   the  uriue 


486  RESULTS  OF  WOUNDS. 

scanty  and  high-coloured.  The  desire  for  food  is  lost,  hut  the 
thirst  is  sometimes  excessive.  Occasionally  the  inflammation 
extends  into  the  articulation  nearest  the  original  injury,  and  the 
case  hecomes  complicated  with  open-joint,  or  abscesses  form 
along  the  course  of  the  absorbents,  the  animal  becoming  even- 
tually farcied  or  glandered. 

Treatment. — In  the  cedematous  form,  the  bowels  are  to  be 
opened  by  a  brisk  cathartic,  the  swollen  parts  frequently 
fomented  with  warm  water,  and  covered  by  a  bandage.  When 
the  cathartic  has  operated,  saline  diuretics,  and  liberal  doses 
of  the  tincture  of  terchloride  of  iron,  are  to  be  administered,  and 
the  food  is  to  be  of  the  best  kind. 

In  the  phlegmonous  form  the  treatment  must  be  more 
energetic.  A  purgative  is  to  be  administered ;  the  excitement 
combated  with  aconite,  which  has  a  most  marked  effect  in 
allaying  the  irritation  and  fever  ;  and  when  the  bowels  are  freely 
moved  by  the  purgative,  the  tincture  of  the  terchloride  of  iron, 
in  doses  varying  from  two  drachms  to  half  an  ounce,  is  to  be 
given  every  four  hours. 

Locally,  the  parts  are  to  be  fomented  with  warm  water,  and 
smeared  with  oil  or  extract  of  belladonna. 

If  abscesses  form  and  give  distinct  indications  of  pointing, 
they  must  be  opened,  but  it  is  advisable  to  abstain  from  the 
use  of  the  bistoury  as  long  as  possible,  inasmuch  as  the 
admission  of  the  atmosphere  into  an  erysipelatous  wound  is  apt 
to  be  followed  by  sloughing  of  the  tissues. 

Cases  of  erysipelas  originating  in  very  trivial  wounds,  and 
succeeding  to  surgical  operations,  have  fallen  under  my  notice. 

TETANUS. 

Tetanus  is  usually  described  as  a  powerful  and  painful  spasm 
of  the  voluntary  muscles,  which  is  long-continued  and  uncon- 
trollable. The  spasm  of  the  muscles  is  that  of  rigid  contraction, 
and  from  its  constancy  and  non-intermitting  character,  it  has 
been  termed  tonic.  It  is  frequently  a  result  of  injury,  althougli 
it  also  occurs  without  obvious  cause ;  hence  it  is  called  traumatic 
and  idiopathic  tetanus.  Of  all  the  domestic  animals,  the  horse  is 
most  liable  to  tetanus.  It  is  but  rarely  seen  in  the  ox  tribe, 
and  when  it  does  occur  in  the  bovine  animal,  it  is  generally  of 
the  idiopathic  form. 


TETANUS.  487 

Traumatic  tetanus  may  result  from  a  very  trivial  injury, 
although  it  is  most  likely  to  do  so  after  a  severe  laceration  or 
puncture,  more  especially  when  nerves  are  injured.  Wounds 
of  the  feet  and  joints,  although  giving  rise  to  a  high  degree  of 
irritative  fever,  seldom  cause  tetanus,  and  in  my  experience 
wounds  in  the  region  of  the  quarters,  thighs,  and  fore  arm,  more 
especially  if  tlie  great  nerves  of  those  parts  are  injured,  are  those 
most  liable  to  cause  it. 

The  operations  which  are  most  commonly  succeeded  by 
tetanus  are  docking,  castration,  the  insertion  of  setons,  and  in 
one  instance  which  fell  under  my  notice,  a  moderate  blister  to 
a  fore  leg  proved  a  cause  of  tetanus. 

Tetanus,  whether  traumatic  or  idiopathic,  is  rarely  seen  in 
certain  districts.  Mr.  Cartwright  of  Whitchurch  informs  me 
that  he  has  never  seen  a  case  of  tetanus  in  his  district,  although 
he  has  practised  there  for  forty-five  years ;  and  during  the  ten 
years  I  practised  in  Bradford  I  saw  but  two  cases,  both  of  which 
were  idiopathic.  In  other  districts  of  the  country,  tetanus,  of 
both  kinds,  is  exceedingly  prevalent. 

Tetanus  is  occasionally  seen  as  an  enzootic  disease,  simul- 
taneously attacking  several  animals  in  the  same  district. 
During  the  summer  of  1858  I  witnessed  ten  cases  in  a 
fortnight.  Some  of  these  were  traumatic,  whilst  the  exciting 
cause  of  the  others  could  not  be  traced.  Some  writers  on 
veterinary  surgery  state  that  tetanus  is  more  apt  to  prevail  in 
cold  than  in  hot  weather.  My  experience  is  contrary  to  this, 
and  that  it  is  mostly  during  warm  weather  that  the  disease 
prevails  to  any  extent,  although  isolated  cases  of  it  occur  at  all 
times  of  the  year. 

There  are  several  varieties  of  the  disease,  and  the  word 
tetanus  is  made  use  of  to  denote  it  generally.  As  a  generic 
term,  it  comprehends  all  the  varieties,  but  when  not  used 
in  this  sense  it  implies  that  the  disease  involves  all  classes 
of  muscles  equally.  When  the  muscles  of  mastication  are 
alone  involved,  it  is  called  trismus.  When  it  chiefly  affects 
the  superior  cervical  and  dorsal  muscles,  causing  the  head 
to  be  elevated  and  the  spine  curved  downwards,  it  is  called 
opisthotonos.  When  the  muscles  of  one  side  are  dffected,  it  is 
csilled  tetanus  lateralis,  ov  pleurosthotonos;  and  in  other  cases — 
rare  even  in  the  human  being — the  inferior  muscles  are  cliiefly 


488  RESULTS  OF  WOUNDS. 

affected,  the  chin  drawn  towards  the  breast,  the  spine  curved 
"backwards,  the  disease  is  named  emprostliotonos.  In  the  lower 
animals,  trismus,  with  opisthotonos,  is  generally  met  with.  I 
have  seen  a  modified  form  of  tetanus  lateralis,  but  the  other 
form — namely,  emprosthotonos — is,  I  think,  unknown  in  either 
horse  or  ox. 

Tetanus,  whatever  be  the  variety,  may  be  acute,  subacute,  or 
even  chronic.  The  acute  is  that  which  is  most  common,  and 
most  fatal ;  it  has  a  tendency  to  involve  the  whole  frame,  and 
to  destroy  life  by  arresting  the  respiratory  movements.  Amongst 
the  variety  of  causes  which  may  produce  tetanus,  in  addition  to 
the  irritation  of  wounds,  I  have  observed  worms  in  the  stomach 
and  intestinal  canal,  collections  of  sand  in  the  large  intestines, 
and  uterine  irritation  after  abortion. 

Traumatic  tetanus  follows  injuries,  whether  inflicted  surgically 
or  otherwise,  in  an  indefinite  but  limited  period  of  time, — in 
some  instances  within  an  hour  after  the  infliction  of  the  injury, 
but  usually  the  occurrence  of  the  spasm  is  not  observed  until 
the  wound  is  nearly  or  quite  healed.  Neglect  in  the  treatment 
of,  the  presence  of  a  foreign  body  in,  or  the  application  of 
irritating  medicaments  to,  a  wound,  is  apt  to  cause  tetanus. 

The  Sym2Jtoms  of  Tetanus. — In  the  earliest  stage  there  will  be 
a  stiffness  of  the  muscles  near  the  seat  of  the  injury  ;  if  a  limb  is 
wounded,  the  animal  will  move  it  with  difficulty ;  the  stiffness 
spreads  over  the  whole  body ;  the  animal  will  begin  to  champ 
his  jaws,  and  grind  his  teeth.  There  is  often  a  flow  of  saliva 
from  the  mouth,  and  a  collection  of  froth  upon  the  lips.  The 
breathing  now  becomes  accelerated,  the  nostrils  dilated,  the  nose 
protruded,  the  membrana  nictitans  pushed  more  or  less  over  the 
^eyes,  which  are  withdrawn  within  their  sockets.  If  the  animal 
be  suddenly  disturbed,  the  superficial  muscles  will  be  seen  to 
twitch  or  tremble ;  the  eyeballs  convulsively  withdrawn  within 
the  orbits,  causing  the  patient  to  show  the  white  of  the  eye 
at  every  convulsive  retraction ;  the  tail  is  suddenly  elevated, 
and  is  maintained  in  that  position  by  an  irregular  clonic  spas- 
modic action  of  the  levator  muscles  so  long  as  the  excitement 
continues. 

At  first  the  pulse  is  not  much  affected,  and  in  all  but  the 
most  severe  attacks  it  continues  undisturbed  for  two  or  three 
days ;  it  has  a  hard,  incompressible  character,  however,  and  as 


TETANUS.  489 

the  disease  advances  it  becomes  accelerated,  harder,  and  more 
incompressible.  When  the  spasm  becomes  general,  the  position 
of  the  various  parts  of  the  body  is  regulated  by  the  action  of 
the  more  powerful  muscles.  The  limbs  are  extended,  flexion  of 
them  is  performed  with  difficulty,  and  the  patient  stands  with 
outstretched  limbs.  The  course  of  the  levator  humeri  can  be 
easily  traced,  and  the  contraction  of  this,  and  other  muscles 
which  act  upon  the  superior  part  of  the  cervical  region, 
cause  the  neck  to  assume  the  appearance  of  what  is  termed 
*'  ewe  neck."  The  peristaltic  motion  of  the  bowels  is  stopped  ; 
the  urinary  bladder  firmly  contracted ;  a  dry,  husky  cough 
comes  on  when  the  animal  attempts  to  swallow,  and  the  act  of 
deglutition  is  performed  with  a  difficulty  which  increases  from 
day  to  day.  The  muscles  of  the  abdomen  are  rigid ;  the  belly 
looks  small  and  hard ;  the  intercostals  act  imperfectly ;  and 
when  the  diaphragm  becomes  involved,  the  breathing  is  per- 
formed with  very  great  difficulty. 

Although  the  spasm  of  tetanus  is  of  the  tonic  or  persistent 
kind,  there  are  exacerbations  of  a  clonic  intermittent  character ; 
and  the  whole  course  of  the  disease  is  marked  by  paroxysms  of 
great  severity  if  the  animal  be  subjected  to  meddling  attendance, 
strong  light,  or  rustling  noises.  In  a  modified  light,  and  when 
the  animal  is  kept  quiet,  the  spasms  are  usually  diminished,  and 
the  exacerbations  much  milder. 

But  little  is  known  about  the  general  pathology  of  tetanus. 
Some  writers  are  of  opinion  that  it  is  due  to  an  exalted  polarity 
of  the  nervous  centres,  excited  by  the  injury  in  the  traumatic 
form,  or  resulting  from  a  mal-condition  of  the  blood,  or  the 
effects  of  cold  acting  upon  the  nerves  of  sensibility  in  the  idio- 
pathic form  of  the  disease. 

In  post-mortem  examinations  of  traumatic  tetanus  I  have  in- 
variably found  the  nerves  leading  from  the  injured  parts  to 
present  some  signs  of  inflammation ;  the  neurilemma  more 
vascular  than  natural,  the  vessels  of  the  spinal  cord  engorged, 
and  the  sub-arachnoid  space  to  contain  some  effusion. 

Treatment  of  Tetanus. — Suppose  the  disease  to  be  caused  by 
docking  or  neurotomy,  the  first  question  to  be  considered  is 
whether  a  portion  of  the  stump  of  the  tail  or  the  end  of  the 
nerve  should  be  removed  or  not.  Some  are  of  opinion  that  the 
nervous  irritation  is  due  to  the  nervous  fibrilloe  of  the  part  being 


490  RESULTS  OF  WOUNDS. 

pressed  upon  by  the  contraction  and  cicatrisation  of  the  reparative 
material  of  the  wound,  and  that  this  explains  the  curious  fact  that 
tetanus  generally  occurs  when  a  wound  is  nearly  or  completely 
healed.  If  this  view  be  correct,  then  further  amputation  of  the 
tail  or  excision  of  the  nerve  would  afford  some  relief.  Experience, 
however,  does  not  warrant  me  in  recommending  this  to  be  done. 
The  wounds,  or  the  seats  of  them,  if  healed,  are  in  all  cases  to 
be  fomented,  and  if  practicable,  poulticed,  the  fomentations  or 
poultices  to  be  medicated  with  a  solution  of  belladonna.  Should 
tetanus  occur  soon  after  an  injury  is  inflicted,  the  wound  should 
be  examined,  and  any  lacerated  or  partially  divided  nerve,  foreign 
body,  or  dead  tissue  removed. 

There  are  some  cases  of  tetanus  so  acute  from  their  com- 
mencement that  it  is  quite  hopeless  to  expect  any  but  a  fatal 
termination ;  and  in  every  case  where  all  the  symptoms  aro 
firmly  established  before  the  fourth  day  of  attack,  death  may 
be  expected.  But  in  cases  where  the  symptoms  are  slowly 
developed,  some  movement  of  the  jaws  still  remaining,  the 
exacerbations  not  very  severe — more  especially  if  the  animal 
possess  a  calm  quiet  temper,  and  lives  over  the  ninth  day, — a 
recovery  may  be  expected. 

The  wound  having  been  properly  attended  to,  the  next  thing 
to  be  done  is  to  place  the  animal  loosely  in  slings ;  this  ought 
to  be  done  early,  and  before  the  nervous  excitability  becomes 
too  great.  If  the  patient  is  comfortably  slung,  he  will  get  used 
to  the  slings  before  the  malady  has  attained  its  height.  I 
recommend  the  slings  because  many  horses  which  are  in  a  fair 
way  of  recovery  lie  or  fall  down  when  the  muscles  begin  to  relax, 
and,  when  down,  struggle  and  fight  to  such  an  extent  that  they 
seldom  recover  from  the  excitement  and  renewed  severity  of 
the  disease  thus  brought  on.  The  surroundings  of  the  patient 
are  of  the  utmost  importance ;  the  stable  must  be  darkened ; 
should  contain  no  other  horses ;  be  situated  in  a  quiet  spot,  re- 
moved from  noises,  and  the  door  must  have  a  lock,  the  key  of 
which  is  to  be  kept  by  one  individual  (the  veterinary  surgeon, 
if  possible),  who  is  to  visit  the  patient,  at  most  twice  a-day,  and 
great  care  must  be  taken  that  the  animal  is  not  tormented  by  flies. 

As  a  rule,  the  desire  for  food  continues  for  several  days ;  the 
thirst  is  considerable,  and  large  quantities  of  nutritious  fluids 
will  be  drunk  with  avidity. 


TETANUS.  491 

The  most  important  particulars  in  the  successful  treatment  of 
tetanus  are  quietude  and  nourishment,  medicinal  agents  playing 
but  a  subordinate  part. 

Quietude  having  been  secured,  nourishment  is  to  be  given  by 
allowing  the  patient  milk  and  thick  gruel  to  drink ;  along  with 
these,  eggs  may  be  mixed  with  advantage.  A  little  hay  or  grass 
placed  in  the  rack  will  often  keep  the  animal  quiet,  although 
the  attempts  to  swallow  sometimes  cause  a  paroxysm. 

The  medicinal  agents  that  have  been  used  in  the  treatment  of 
tetanus  are  numerous :  purgatives,  opium,  tobacco.  Calabar  bean, 
woorara,  prussic  acid,  calomel,  chloroform,  belladonna,  hyoscya- 
mus,  cannabis  indicus,  arsenic,  chloral-hydrate,  &c.,  &c.  I  have 
treated  tetanus  in  various  ways,  and  am  satisfied  that  administra- 
tion of  a  dose  of  aloes,  if  it  can  be  given  without  exciting  the 
horse,  followed  by  belladonna — which  is  only  to  be  given  when  the 
patient  shows  symptoms  of  great  excitement — is  the  best  method 
of  treatment.  The  Calabar  bean,  given  in  doses  of  two  to  four 
ounces  of  the  tincture,  has  a  most  wonderful  effect  upon  the 
spasms,  the  pulse,  and  the  breathing;  but  this  effect  is  very 
transient,  and  is  succeeded  by  a  return  of  the  spasms  with  great 
severity.  The  seat  of  the  wound  is  from  time  to  time  to  be 
smeared  with  the  extract  of  belladonna ;  and  when  the  bella- 
donna is  administered  internally,  it  should  be  either  dissolved  in 
the  animal's  mash  or  drink,  or  else  placed  between  his  teeth, 
allowance  being  made  for  the  probable  waste. 

The  prussic  acid  treatment,  so  highly  recommended  by  the 
late  Mr.  Lawson  of  Manchester,  has,  with  me,  proved  to  have 
no  special  superiority ;  and  doubtless  the  success  of  Mr. 
Lawson  in  the  treatment  of  tetanus  was  due  more  to  the  tact 
and  skill  of  the  man  than  to  any  virtue  contained  in  the 
remedy. 

Those  cases  of  tetanus  which  terminate  favourably  take  usually 
about  six  weeks  before  the  spasmodic  contractions  entirely  sub- 
side. As  soon  as  they  can  eat  good  food,  they  are  to  have  it 
liberally.  Corn,  roots,  and  hay  in  the  winter ;  corn  and  grass 
in  the  summer,  and  a  few  doses  of  tonic  medicine,  such  as  the 
sulphate  of  iron,  will  materially  assist  convalescence. 

In  the  fatal  cases  of  tetanus,  the  breath  very  frequently  be- 
comes foetid  prior  to  death,  and  if  the  mouth  be  examined,  a 
quantity  of  slate-coloured  epithelium  will  be  found  on  the  inner 
surfaces  of  the  lips,  gums,  and  tongue. 


49^  RESULTS  OF  WOUNDS. 

The  treatment  of  idiopathic  tetanus  requires  no  special  notice. 
It  is  to  be  conducted  upon  the  principles  already  laid  down,  the 
only  difference  being  that  no  local  applications  are  necessary. 
It  is  generally  supposed  that  the  idiopathic  is  more  amenable  to 
treatment  than  the  traumatic ;  but,  so  far  as  I  can  judge  from 
my  own  experience,  it  is  even  the  more  fatal  form ;  and  I  find 
that  I  am  supported  in  this  conclusion  by  the  veterinary  surgeons 
of  the  neighbourhood  of  Edinburgh. 


CHAPTER  XXVIIL 

DISEASES  AND  INJUEIES  OF  THE  FACIAL  HEGION. 

WOUNDS  OF  THE  LIPS TUMOURS BRUISES  OF  THE  MOUTH AFFEC- 
TIONS OF  THE  BUCCAL  MEMBRANE SPORADIC  APHTHiE — PARA- 
LYSIS OF  THE  LIPS OPEN  PAROTID  DUCT SALIVARY  CALCULI 

PTYALISM — RANULA EPULIS GLOSSITIS— ULCER   AND   INDURA- 
TION   OF    THE    TONGUE   IN    HORNED    CATTLE PARALYSIS  OF    THE 

TONGUE. 

DISEASES  AND  INJURIES  OF  THE  MOUTH,  TONGUE, 
(ESOPHAGUS,  ETC. 

Wounds  of  the  lips  call  for  no  special  notice,  further  than  that 
they  are  to  be  treated  upon  the  conservative  method ;  that  is 
to  say,  an  endeavour  must  always  be  made  to  bring  about  the 
union  of  the  divided  parts.  It  is  a  very  cominon  practice,  when 
a  lip  is  partly  cut,  with  the  divided  portions  hanging  loosely,  to 
remove  them  with  a  sharp  pair  of  scissors  or  knife,  instead  of 
bringing  them  together  with  sutures,  and  retaining  them  in  ap- 
position till  they  are  united.  I  want  to  impress  upon  the  young 
practitioner  the  importance  of  never  removing  any  portion  of 
injured  lips  until  he  sees  that  their  reunion  is  an  impossibility; 
and  rather  than  cut  them  off,  he  should  allow  them  to  be  separ- 
ated by  the  process  of  sloughing ;  for  a  lip  mutilated  by  meddling 
surgery  remains  a  permanent  blemish,  leaving  the  teeth  exposed 
and  the  powers  of  prehension  greatly  interfered  with. 

TUMOUR  OF  THE  LIP. 

A  tumour  sometimes  forms  on  the  lips;  at  first  firm  and 
solid  to  tlie  touch,  of  a  variable  size,  occurring  either  spon- 
taneously or  as  the  result  of  a  sting,  and  which  in  a  day  or 
two  suppurates  and  bursts.  It  requires  little  treatment  except 
fomentations. 


494  DISEASES  AND  INJUEIES  OF  THE  FACIAL  REGION. 


BrvUISES  OF  THE  MOUTH. 

Yarious  parts  of  the  mouth,  tongue,  and  the  rami  of  the  jaw 
are  bruised  and  injured  by  the  teeth,  and  by  severe  bits.  These 
have  already  been  alluded  to  under  Diseases  of  the  Bones,  and 
I  need  say  but  little  here;  but  I  would  recommend  that  all 
"  pulling  horses  "  should  be  ridden  or  driven  in  easy  bits — the 
ring-snaffle  bit  in  preference  to  all  others.  I  have  often  been 
called  to  horses  whose  mouths  have  been  hot,  swollen,  and  the 
mucous  membrane  torn  by  the  bit,  the  lips  bleeding,  or  the 
whole  of  the  parts  which  are  situated  beneath  the  bit  black 
from  extravasated  blood ;  and  I  have  heard  the  rider  exclaim, 
"  The  brute  nearly  pulled  my  arms  off." 

Many  horses  are  ruined,  as  well  as  tortured,  by  severe  bits 
and  heavy  hands ;  and  it  may  be  often  seen  that  a  horse  is  so 
tender  in  the  mouth  that  he  will  scarcely  face  the  bit,  until  he 
is  urged,  perhaps  by  a  whip  he  cannot  endure,  and  the  spurs 
which  he  abominates.  However,  forward  he  must  go ;  his  pride 
is  insulted,  his  dignity  touched,  his  courage  raised,  and  off  he 
goes,  harder  than  was  bargained  for,  pulling  his  rider  or  driver's 
arms  off — and  serve  him  right ;  but  at  the  expense  of  his  own 
delicate  mouth,  from  which  he  will  suff'er  for  many  a  day.  I  have 
a  horse  at  the  present  time,  a  highly-bred  one,  with  courage, 
spirit,  action,  docility,  and  a  most  beautiful  m.outh,  provided  he 
is  driven  in  a  snaffle-bit ;  but  if  a  curb-bit  is  put  on,  he  will 
scarcely  face  it  for  the  first  few  miles ;  but  when  warmed  to  his 
work,  no  man  could  hold  him.  He  pulls  and  pulls,  perhaps 
suddenly  stops,  shakes  his  head,  or  leans  to  one  side  of  the  road. 
Indeed,  he  was  so  dreadfully  bad  in  his  behaviour  when  I  first 
bought  him,  that  I  thought  he  was  useless ;  but  when  a  proper 
bit  was  tried,  I  had  no  further  trouble  with  him.  I  am  satisfied 
that  many  hundreds  of  horses  are  the  same  as  my  own. 

When  a  horse  is  injured  by  the  bit  or  curb,  time  should  be 
allowed  for  the  mouth  and  jaw  to  regain  their  natural  condition 
before  the  animal  is  bitted,  and  tlien  the  bit  should  be  of  the 
lightest  and  easiest  description. 

AFFECTIONS  OF  THE  BUCCAL  MEMBRANE. 

Lampas,  barbs,  paps,  &c.,  are  terms  applied  by  the  ignorant 
to  fancied  diseases ;  the  first  to  the  prominent  palatine  bars 


AFFECTIONS  OF  THE  BUCCAL  MEMBRANE.  495 

of  the  young  horse,  the  latter  to  the  swollen  papilloe  of  the 
tongue  and  cheeks.  The  lampas  is  supposed  to  interfere  with 
the  masticatory  powers  of  the  animal,  and  the  veterinary  surgeon 
is  frequently  requested  to  burn  or  otherwise  remove  it,  and  if 
he  declines,  some  barbarous  fellow  very  soon  undertakes  the 
task.  If  the  veterinarian  can  convince  the  owner  or  driver  of 
the  horse  that  an  operation  is  unnecessary,  that  the  bars  of  the 
young  horse  are  always  prominent,  that  they  are  reddened 
during  the  process  of  dentition,  and  that  those  of  the  old  may 
be  swollen  from  some  internal  ailment,  as  indigestion,  which  a 
little  medicine  will  remove,  well  and  good ;  but  if  it  be  an 
impossibility  by  force  of  argument  to  impress  this  conviction 
upon  the  client,  it  is  better  for  the  veterinary  surgeon  to  operate, 
although  it  is  against  his  conviction,  than  allow  the  horse  to  be 
tortured  by  some  ignorant  and  barbarous  pretender. 

Barbs  and  paps  are  swollen  papillae,  or  perhaps  the  orifices  of 
labial,  sublingual,  or  submaxillary  glands,  mistaken  for  growths, 
and  cut  oJBP.  I  should  scarcely  have  mentioned  this  in  a  book 
of  this  kind,  except  that  one  continually  meets  with  men  w^ho 
believe  in  anything  that  is  sufficiently  absurd.  The  papillae,  or 
even  the  orifices  of  the  gland  ducts,  may  be  swollen  during 
dentition,  catarrhal  affections,  and  indigestion ;  but  they  are 
never  to  be  mutilated  by  being  cut  off.  Eemove  the  source  of 
irritation,  and  they  will  soon  disappear.  If  the  mouth  seem 
painful,  and  if  there  is  a  dribbling  of  saliva,  a  mild  astringent 
wash  of  borax  or  alum  will  tend  to  remove  the  pain,  and 
be  a  source  of  comfort  to  the  patient.  If  the  stomach  or 
bowels  are  at  fault,  gentle  aperients,  antacids,  and  stomachics 
will  have  to  be  administered,  the  quality  of  the  food  being  at 
the  same  time  looked  into. 


SrORADIC  APHTHA,  OR  THRUSH. 

A  crop  of  small  vesicles,  or  even  pustules,  occasionally  ap- 
pears in  the  mouth  of  horses,  particularly  during  the  process  ot 
dentition,  the  eruption  being  called  aphthae,  or  thrush.  In 
cattle,  sheep,  and  pigs  these  eruptions  are  not  at  all  uncommon, 
the  buccal  membrane  peeling  off  in  patches,  leaving  the  tongue, 
gums,  and  mouth  raw  and  painful,  and  rendering  the  aniiaal 
unable  to  take  food  without  great  difficulty. 


406  DISEASES  AND  INJURIES  OF  THE  FACIAL  EEGION. 

Treatment. — Eemoval  of  cause,  cool  astringent  washes  to 
the  mouth,  and  if  ulcers  form  which  have  no  disposition  to 
heal,  the  nitrate  of  silver  is  to  be  applied. 


PARALYSIS  OF  THE  LIPS, 

Generally  met  with  in  horses  which  are  compelled  to  wear 
heavy  bridles,  as  those  used  for  hearses,  mourning  coaches,  &c., 
or  in  any  class  of  harness-horse  whose  harness-bridle  fits  him 
badly.  It  is  called  in  Yorkshire  dropped-lip ;  and  the  term  is 
very  expressive,  for  the  lips  are  pendulous,  the  lower  one  semi- 
everted,  and  the  horse's  face  seemingly  lengthened  by  this  pen- 
dulosity.  They  hang  elongated,  flaccid,  and  powerless;  the 
saliva  flows  from  the  mouth,  in  consequence  of  the  animal  being 
unable  to  approximate  his  lips.  When  attempting  to  drink  he 
pushes  his  head  into  the  water  up  to  his  eyes ;  and  whilst  feed- 
ing he  is  compelled  to  gather  his  food  with  his  teeth  only.  He 
therefore  feeds  from  the  bottom  of  the  manger,  pushing  his  nose 
deeply  into  his  corn.  He  champs  whilst  eating,  often  drops  his 
mouthful,  and  generally  quids  his  hay. 

This  affection  is  due  to  an  injury  to  the  portio  dura,  or  seventh 
pair  of  nerves.  If  both  the  nerves  are  injured,  both  sides  of  the 
lips  will  be  paralysed,  causing  the  pendulosity  already  men- 
tioned; but  if  the  injury  is  limited  to  one  nerve,  as  is  more 
usually  the  case,  the  lips  will  }>e  drawn  from  the  affected  side, 
and  the  horse's  mouth  will  ap])ear  crooked. 

The  seventh  pair  of  nervi;s  convey  the  motor  power  to  a 
variety  of  muscles,  but  more  particularly,  as  bearing  upon  the 
subject  now  under  consideration,  to  those  of  the  lips,  nose,  and 
lower  part  of  the  face.  These  nerves  pass  out  of  the  cranium 
by  the  stylo-mastoid  foramen  of  the  petrous  temporal  bone ;  at 
first  deeply  buried  undei'  the  parotid  gland,  they  afterwards 
pass  between  tlie  glands  and  guttural  pouches,  to  gain  the  pos- 
terior border  of  the  lower  jaw,  round  the  neck  of  which  they 
turn,  and,  mounting  to  the  external  surface  of  the  masseter 
muscle,  run  downwards  on  the  cheek  quite  subcutaneously.  In 
well-bred  fine-coated  horses  they  can  be  seen  very  plainly  on 
the  sides  of  the  cheeks,  and  being  thus  superficially  situated, 
are  liable  to  be  injured  by  the  pressure  of  a  heavy  ill-fitting 
bridle.     The  injury  causes  inflammation  of  the  nerve  (neuritis) 


PARALYSIS  OF  THE  LIPS.  407 

and  its  neurilemma,  with  swelling  and  exudation.  The  exudate 
pressing  upon  the  substance  of  the  nerve,  adds  to  the  already 
existing  loss  of  function.  If  the  cheeks  are  carefully  manipu- 
lated, the  swollen  nerves  can  be  distinctly  felt. 

Some  writers  attribute  this  paralysis  to  indigestion  or  other 
obscure  causes.  But  I  cannot  conceive  how  it  can  arise  except 
from  that  already  stated — and  this  is  the  only  cause  I  have  yet 
met  with  in  my  practice — or  from  disease  of  the  petrous  tem- 
poral bone,  through  which  the  portio  dura  passes,  and  disease  of 
the  brain. 

Treatment. — Eemoval  of  all  pressure  from  the  head  and  face. 
If  the  animal  is  tied  in  the  stall  by  a  head-collar,  this  must  be 
removed  and  replaced  by  the  neck-strap ;  or  wh.ut  is  better,  it 
should  be  turned  loose  into  a  box.  The  pressure  of  the  head 
collar  may  seem  trivial,  but  it  is  sufficient  to  retard  the  progress 
of  recovery  for  an  indefinite  period.  The  food  should  be  soft, 
and  placed  in  a  convenient  position ;  a  deepish  manger  is  the 
best,  as  the  horse  is  apt  to  toss  it  about  and  waste  much,  owing 
to  the  absence  of  prehension.  A  purgative  is  useful,  assisting 
to  remove  the  inflammation  of  the  nerves.  Fomentations  and 
rubefacients  are  to  be  applied  to  the  masseter  region;  and  if 
these  prove  ineffective,  the  absorption  of  the.  exudate  must  be 
excited  by  repeated  applications  of  the  biniodide  of  mercury 
ointment.  It  is  quite  unnecessary  to  administer  nervine  tonics, 
as  nux  vomica,  for  the  paralysis  depends  upon  inflammation  of 
the  nerve,  and  its  continuance  upon  the  pressure  of  the  exudate, 
the  removal  of  which,  if  organic  change  in  the  nerve  tissue 
has  not  been  induced,  will  restore  the  power  to  the  paralysed 
muscles.  The  biniodide  may  be  assisted  in  its  action  by  the 
internal  administration  of  iodine  qr  its  salts.  Commonly,  this 
treatment  will  suffice,  but  should  the  loss  of  power  still  continue, 
setons  over  the  cheeks,  or  the  actual  cautery,  are  to  be  tried.  I 
have  seen  a  great  number  of  cases,  but  only  one  which  was  in- 
curable. 


AFFECTIONS  OF  THE  DUCTS  AND  GLANDS  OF  THE  MOUTH. 
OPEN  PAROTID  DUCT. 

Steno's  duct  winds  round  the  inferior  maxillary  bone,  in  com 

2k 


498  DISEASES  AND  INJUEIES  OF  THE  FACIAL  REGION. 

pany  with  the  submaxillary  artery  and  vein,  and  enters  the 
mouth  between  the  second  and  third  upper  molar  teeth.  Its 
course  across  the  jaw  is  superficial,  and  hence  it  is  liable  to  be 
opened  by  direct  violence,  as  kicks  or  heavy  blows,  or  by  ulcera- 
tion of  its  coats  when  involved  in  the  abscess  of  strangles. 
From  whatever  cause  it  is  opened,  sahva  is  discharged  from  the 
wound,  instead  of  flowing  into  the  mouth.  When  the  animal  is 
not  feeding  the  discharge  is  very  slight  indeed;  but  during 
mastication,  more  especially  if  the  food  be  dry,  the  flow  is  most 
abundant,  as  the  parotid  gland  always  secretes  in  direct  ratio  to 
the  dryness  of  the  food. 

Treatment. — Various  means  have  been  resorted  to  for  the 
purpose  of  re-estabhsliing  the  communication  between  the  gland 
and  mouth.  If  the  injury  is  not  recent,  the  mere  closing  of  the 
external  wound  is  insufficient,  for  the  reason  that  the  duct 
between  the  wound  and  the  mouth  is  no  longer  pervious,  being 
obhterated  by  the  inflammatory  swelling.  The  first  step  in  the 
treatment  of  open  parotid  duct  is  to  make  an  opening  between 
the  wound  and  mouth,  along  the  course  of  the  original  canal,  if 
j)0ssible ;  if  not,  an  artificial  channel  will  have  to  be  formed,  by 
introducing  a  seton,  from  the  ulcer  into  the  mouth,  which  should 
remain  for  four  or  five  days,  or  until  it  has  made  a  suj)purating 
channel.  It  is  then  to  be  withdrawn,  the  external  wound 
brought  together  by  suture  and  collodion,  or  styptic -colloid 
thickly  applied.  When  the  adhesive  dressing  is  quite  firm,  a 
little  food  is  to  be  given,  in  order  to  excite  the  secretion  of 
saliva,  for  if  the  gland  is  quiescent  for  any  length  of  time,  the 
artificial  duct  is  apt  to  close  by  adhesion  of  its  sides.  Great 
care  must  be  taken  that  the  dressings  are  in  no  way  disturbed 
for  several  days  after  they  are  applied ;  and  in  order  to  support 
the  animal  without  exciting  the  secretion  of  any  great  quantity 
of  saliya,  such  food  as  eggs,  milk,  and  tliick  gruels  must  be 
allowed ;  for  if  dry  food  be  given  the  secretion  will  be  calculated 
to  loosen  and  disturb  the  adhesive  aj)plications,  to  force  the  lips 
of  the  wound  asunder,  and  to  reduce  the  fistula  to  its  original 
condition. 

If  the  treatment  by  seton  is  unsuccessful,  the  gland  should  be 
destroyed  by  injecting  into  its  substance,  through  the  opening 
already  existing  in  the  duct,  the  following  solution : — Nitrate  of 
silver,  half  a  drachm  ;  nitric  acid,  one  drachm  ;  water,  one  ounce. 


OPEN  PAROTID  DUCT.  499 

A  powerful  syringe  will  be  necessary  to  force  the  injection  into  all 
the  ramifications  of  the  gland.  It  arrests  the  discharge,  by  causing 
such  an  amount  of  inflammation  in  the  substance  of  the  gland 
as  to  destroy  its  secerning  functions ;  the  tubules  and  ducts  be- 
come filled  with  adhesive  lymph,  causing  the  adhesion  of  their 
sides,  the  destruction  of  gland  cells,  and  such  an  alteration  in  its 
whole  structure,  that  it  finally  becomes  converted  into  a  solid 
indurated  mass  or  tumour,  which  is  gradually  removed  by  absorp- 
tion. 

It  must  be  distinctly  understood  that  neither  the  insertion  of 
a  seton  nor  the  destruction  of  the  gland  are  to  be  attempted  in 
recent  cases;  nor  should  caustics  or  the  actual  cautery  be  at 
any  time  applied.  In  a  recently  opened  duct  the  wound  should 
be  treated  by  suture  and  collodion,  and  the  animal  forced  to 
abstain  from  all  soM  food  for  at  least  three  days  after  the  acci- 
dent. He  must  have  gruel,  milk,  &c.,  to  drink,  and  be  muzzled, 
to  prevent  him  eating  his  bedding.  Nauseating  with  small 
doses  of  aloes  is  very  useful,  destroying  the  desire  for  food,  and 
assisting  materially  in  the  compulsory  quietude  of  the  jaws. 
When  the  saliva  is  partly  discharged  into  the  mouth,  and  partly 
through  a  small  ulcer  out  of  the  duct,  a  smart  blister  will 
generally  bring  about  the  closure  of  the  opening.  The  removal 
of  the  gland  by  excision,  as  recommended  by  the  continental 
veterinarians,  is  never  required. 

SALIVARY  CALCULI. 

These  concretions  form  chiefly  in  the  parotid,  sublingual,  and 
submaxillary  ducts.  They  are  caused  by  an  accidental  nucleus, 
such  as  a  small  piece  of  hay  or  corn  penetrating  the  canal — to 
which  the  salts  of  the  saliva  adhere,  forming  roundish  or  mul- 
berry concretions  blocking  up  the  duct,  wliich  becomes  enlarged 
and  distended  with  saliva.  The  treatment  is — removal,  by  mani- 
pulation into  the  mouth,  if  possible,  or  through  an  opening  made 
by  th^  knife,  and  treating  the  wound  so  made  upon  the  plan  re- 
commended for  recently  opened  duct. 

Sometimes  an  oat  insinuates  itself  into  the  orifice  of  the  parotid 
duct,  producing  distension  of  it  by  saliva,  causing  it  to  appear  as 
a  pendulous  sac  on  the  borders  of  the  jaw.  The  foreign  body 
must  be  removed  through  the  mouth. 


500  DISFASES   AND  INJURIES  OF  THE  FACIAL  REGION. 

According  to  Percivall,  salivary  calculi  are  mainly  composed  of 
the  carbonates  and  phosphates  of  lime.  I  have  only  one  speci- 
men in  my  possession,  presented  by  Mr.  Gloag,  and  it  is  composed 
of  organic  matters,  namely,  albumen,  mucus,  and  cholesterine 
with  a  mere  trace  of  salts. 

EXCESSIVE  SECRETION  OF  SALIVA — PTYALISM. 

This  results  from  disease  of  the  teeth ;  some  peculiar  foods, 
as  green  food  charged  with  mustard ;  mercurialism ;  any  source 
of  irritation  in  the  mouth  ;  from  the  poison  of  epizootic  aphthae; 
and  rinderpest. 

Mercurial  ptyalism  is  easily  induced  in  horned  cattle  by 
small  doses  of  calomel,  and  by  mercurial  dressings  to  the  skin. 
In  the  horse,  larger  doses  are  required;  although  in  one  case 
which  came  under  my  notice  two  drachms  of  calomel  were  suffi- 
cient to  cause  alarming  salivation  and  other  signs  of  mercurial 
poisoning. 

The  treatment  in  all  cases  is  the  removal  of  the  cause,  re- 
peated washings  of  the  mouth  with  cold  water,  and  mild  as- 
tringents, such  as  vinegar,  borate  of  soda,  or  aluna. 

RANULA 

Consists  in  the  formation  of  a  cyst  in  one  of  the  ducts  of  the 
sublingual  gland,  varying  in  size  from  a  walnut  to  a  hen's  egg, 
containing  a  ropy  fluid.     (See  chapter  on  Tumours.) 


EPULIS. 

(See  Photo-lithograph,  Plate  IV.,  Fig.  1.) 

A  tumour  of  the  gum,  often  of  a  simple  growth  of  the  same 
consistence  as  the  structure  from  which  it  grows,  and  not  hkely 
to  be  reproduced  when  the  exciting  cause  has  been  removed, 
and  the  disease  extirpated.  Its  frequent  cause  is  caries  of 
some  parts  of  the  molar  teeth.  The  lower  jaw  is  its  most  com- 
mon seat;  it  commences  at  the  root  of  the  molars,  or  in  the 
alveolar  ridges.  The  size  and  extent  of  epuhs  are  various ;  it 
may  be  confined  to  the  gum  between  two  teeth,  or  it  may 
involve  several,  if  neglected,  and  partake  of  a  malignant  character, 
as  the  specimen  portrayed  in  Photo-lithograph,  Plate  IV.,  Fig.  2. 


EPULIS.  501 

The  smaller  tumour  (Fig.  1)  is  in  tlie  mouth  of  the  sheep ; 
the  larger  (Fig.  2),  in  the  cow  ;  the  first  is  benign,  and  the  latter 
malimant. 

The  two  figures  in  the  photo-lithograph  show  the  difference 
between  the  benign  and  malignant  forms  very  distinctly ;  the 
first  was  smooth  on  the  surface,  of  slow  growth,  and  seemed  to 
be  unattended  with  pain,  but  interfered  with  the  process  of 
mastication ;  the  other  ragged,  of  rapid  growth,  frequently  bleed- 
ing, and  seemingly  giving  the  animal  much  pain,  and  was  accom- 
panied by  infiltration  into  the  surrounding  bones  and  hard  palate 
of  the  characteristic  cancer  matter. 

The  benign  tumour  may  be  removed  with  advantage;  the 
operation  being  modified  according  to  its  size  and  situation. 
One  tooth  or  more  must  always  be  extracted,  in  order  that  the 
proceeding  be  effectual.  After  these  have  been  removed,  the 
tumour  must  be  surrounded  by  an  incision  made  with  a  strong 
knife,  and  if  need  be,  part  of  the  alveolar  process  is  to  be  taken 
away  by  the  bone  forceps.  If  the  tumour  is  far  back  in  the 
mouth,  it  will  be  advantageous  to  divide  the  cheek,  in  order  to 
expose  the  parts  fully  to  view,  and  to  obtain  ready  access  to 
them.  The  wound  so  made  will  heal  very  well  if  properly 
secured.  I  have  met  with  epulis  in  cattle  and  sheep,  but  never 
in  the  horse.  Generally,  those  in  the  upper  jaw  are  of  rapid 
and  unlimited  growth,  those  in  the  lower  of  slow  growth  and 
benign  nature ;  but  if  not  completely  removed,  they  are  apt  to 
grow  again. 


AFFECTIONS  OF  THE  TONGUE. 

GLOSSITIS. 

Glossitis,  or  inflammation  of  the  tongue,  when  occurring  as  a 
primary  disorder,  is  consequent  on  injuries,  scalds,  or  chemical 
irritants.  The  tongue  is  injured  and  inflamed  by  being  included 
in  the  halter  when  the  "  cavil  is  put  in  the  mouth ;"  I  have  seen 
it  cut  in  two  by  such  carelessness.  The  proper  way  to  put  the 
halter  in  the  mouth  is  to  let  the  tongue  go  free,  but  a  careless 
man  will  include  the  tongue  in  the  loop,  and  thus  inflict  a 
violent  injury.  The  tongue  may  be  bitten  severely  by  the 
animal  himself,  or  wounded  by  sharp  and  irregular  teeth.    Again 


502  DISEASES  AND  INJURIES  OF  THE  FACIAL  REGION. 

it  has  "been  cut  and  severely  wounded  by  a  cruel  attendant  out 
of  spite ;  and  scalded  by  hot  drink,  or  irritated  by  such  remedies 
as  ammonia  or  turpentine  given  insufficiently  diluted.  The 
irritation  from  ammonia,  caustic  potash,  or  soda,  may  be  easily 
recognised,  the  buccal  membrane  being  dissolved  by  the  irritant. 
The  tongue  hangs  out  of  the  mouth  inflamed,  swollen,  having  a 
soft  saponaceous  feel ;  its  covering  peeling  off  as  a  semi-trans- 
parent bluish- white  material;  the  tongue  substance  very  red, 
painful,  and  injected ;  the  cheeks  in  the  same  condition.  Treat 
Avith  cold  astringent  lotions,  vinegar  and  water  answering  two 
purposes — (1),  neutrahsing  any  remaining  alkali,  and  (2)  forming 
a  grateful  application  to  the  inflamed  part. 

Wounds  of  the  tongue  have  to  be  treated  on  conservative 
principles.  Nothing  must  be  destroyed,  cut  off,  or  removed ; 
but  all  torn  edges  brought  into  apposition,  and  held  so  by  proper 
sutures.  A  horse  with  half  a  tongue  will  feed  moderately  well, 
and  keep  his  condition,  but  he  always  requires  extra  care  and 
attention,  and  he  is  less  valuable  in  the  market.  It  therefore 
behoves  the  veterinary  surgeon  to  save  as  much  as  he  can  of 
this  organ  when  at  all  mutilated;  but  if  a  portion  be  really 
gangrenous,  it  must  be  excised. 


ULCERS  OF  THE  TONGUE, 

Are  often  caused  by  diseased  and  irregular  teeth ;  dirty,  foul, 
rusty  bits ;  some  kinds  of  food ;  or  they  may  appear  as  a 
secondary  affection,  depending  upon  indigestion.  The  causes 
must  be  removed  in  all  cases,  and  the  ulcers  treated  with  the 
nitrate  of  silver,  alum,  or  borax ;  chlorate  of  potash  makes  a 
nice  wash  to  the  parts ;  it  may  also  be  given  internally,  when 
the  ulcers  depend  upon  internal  causes. 

Horned  cattle  are  subject  to  induration  of  the  tip  of  the 
tongue.  It  arises  from  no  ostensible  cause,  and  is  generally 
incurable ;  and  as  it  interferes  with  the  powers  of  prehension, 
the  animal  rapidly  loses  flesh,  and  should  be  slaughtered  at  an 
early  stage  of  the  disease. 

PARALYSIS  OF  THE  TONGUE. 

A  paralysed  condition  is  generally  present  when  the  brain  is 


PARALYSIS  OF  THE  TONGUE.  503 

extensively  diseased,  or  sufifering  from  the  pressure  of  tumours, 
serum,  pus,  or  extravasated  blood.  It  may  also  be  induced  by 
forcible  traction  being  applied  to  the  tongue  by  the  attendant 
when  giving  balls  or  other  medicines ;  this  not  only  produces 
paralysis,  but  otherwise  seriously  injures  the  tongue.  The 
symptoms  of  paralysis  of  the  tongue  are — the  tongue  hanging 
out  of  the  mouth,  the  animal  unable  to  draw  it  in,  and  a 
dribbling  of  saliva  from  the  mouth. 

It  is  good  practice  in  all  cases  of  disease  or  injury  of  the 
tongue,  when  it  protrudes  from  the  mouth,  to  force  it  into  its 
proper  position  ;  retaining  it  there  by  a  bandage  placed  round  it 
and  the  lower  jaw.  When  the  tongue  hangs  out  of  the  mouth 
for  any  length  of  time,  it  is  dried  by  the  evaporation  of  its 
moisture,  cracks,  and  ulcerates  upon  its  surface,  and  becomes 
exceedingly  painful,  swollen,  and  inflamed. 

Abscesses  sometimes  appear  at  the  root  of  the  tongue  and 
isthmus  faucis,  interfering  with  deglutition,  and  giving  rise  to 
cough.  The  mouth  is  to  be  examined,  and  the  abscesses  opened 
by  puncture  or  by  laceration  with  the  finger. 


CHAPTER  XXIX. 

DISEASES  AND  INJURIES  OF  THE  FACIAL  REGION — Continued. 

PARROT-MOUTH IRREGULARITIES    OF    THE    TEETH DISEASES    OF   THE 

ALVEOLAR    PROCESSES CARIES    OF    THE    TEETH DISEASES    OF 

DENTITION DENTAL    IRRITATION    IN    YOUNG    CATTLE DENTAL 

COUGH  IN   YOUNG  HORSES DENTITION  FEVER SUPERNUMERARY 

TEETH — DISEASES   OF   THE    FACIAL    SINUSES — OZCENA,    OR   NASAL 
GLEET. 

DEFOEMITIES  OF  THE  MOUTH  AND  lEEEGULARITIES 
OF  THE  TEETH. 

Parrot-Mouth. — This  is  a  well-kno^vn  deformity,  and  consists 
in  the  upper  incisor  teeth  projecting  in  front  and  overhanging 
the  lower  ones,  to  an  extent,  in  some  instances,  of  as  much  as 
two  inches ;  in  such  cases  the  lower  incisors  meet  the  palatine 
ridges  or  "  bars  "  when  the  mouth  is  closed. 

The  teeth  of  both  jaws  become  much  elongated,  not  being 
worn  off  by  the  attrition  which  keeps  them  at  a  proper  length 
when  they  meet  naturally. 

A  horse  with  a  parrot-mouth  will  feed  from  the  manger  very 
well,  but  if  turned  to  grass  he  experiences  a  difficulty  in  collecting 
his  food.  On  this  account  a  horse  with  a  parrot-mouth  is  not 
so  valuable  as  he  otherwise  would  be. 

If  the  lower  incisors  become  so  long  as  to  bruise  and  other- 
wise injure  the  "  bars  "  and  roof  of  the  mouth,  they  will  require 
to  be  shortened  with  a  rasp ;  the  upper  teeth  may  at  the  same 
time  be  shortened  also. 

The  upper  jaw  is  naturally  broader  from  side  to  side  than 
the  lower.  If  tliis  natural  formation  is  carried  beyond  a  certain 
extent,  the  molar  teeth  do  not  approximate  during  mastication, 
and  consequently  a  ridge  of  unworn  tooth  material  is  left  on 
the  external  aspect  of  the  upper,  and  on  the  inner  sides  of  the 


IRREGULARITIES  OF  THE  TEETH.  505 

lower  teetli,  wounding  the  tongue  and  clieeks,  and  causing  what 
is  vulgarly  termed  "  quidding." 

This  malformation  may  be  due  to  the  rami  of  the  lower  jaw 
being  unusually  close  together,  or  to  what  more  rarely  occurs, 
the  increased  breadth  of  the  upper  maxilla  ;  in  either  case,  the 
result  is  the  same,  namely,  the  prevention  of  the  natural  grind- 
ing motion  of  the  jaws  by  the  overlapping  of  the  unworn  surfaces. 

The  treatment  in  such  cases  can  only  be  palliative,  and  consists 
in  the  periodical  rasping  of  the  edges  of  the  teeth,  and  feeding 
the  animal  on  soft  food. 

The  teeth,  both  incisors  and  molars,  are  sometimes  irregularly 
placed  in  the  mouth,  the  irregularities  of  the  incisors,  both  as  to 
l)Osition  and  number,  being  more  common  than  those  of  the 
molars ;  and  they  seldom  cause  any  disease  or  inconvenience, 
unless  when,  projecting  beyond  a  moderate  length,  they  bruise 
or  otherwise  injure  the  opposing  jaw.  They  must  either  be 
removed  or  rasped  down  to  a  moderate  length.  Their  removal 
is  a  very  difficult  matter,  indeed  scarcely  possible  without 
fracture  of  the  jaw ;  but  they  may  be  reduced  by  the  rasp  very 
easily. 

The  irregularities  of  the  molars  are  of  much  greater  import- 
ance, and,  independently  of  those  already  described  as  depending 
uj)on  the  want  of  uniformity  in  the  width  of  the  jaws,  the  two 
opposing  rows  may  be  of  unequal  length.  Thus  the  upper  row 
may  be  longer  than  the  opposing  lower  row ;  in  this  case,  either 
the  first  or  last  molar  in  the  upper  row,  as  the  case  may  be — 
and  it  is  sometimes  the  one,  sometimes  the  other — not  being 
worn  down  by  attrition,  becomes  elongated  to  such  an  extent 
as  to  cause  extensive  disease  in  the  lower  jaw.  Again,  the  rows 
in  the  lower  jaw  may  be  longer  than  those  of  the  upper ;  in  this 
case,  the  unopposed  teeth  will  grow  to  such  an  extent  as  to 
cause  disease  of  the  superior  maxillary  bone,  and  even  to 
perforate  into  the  superior  maxillary  sinus.  In  such  cases  it  is 
necessary  that  the  sharp  projection  be  removed.  When  situated 
anteriorly,  this  is  not  difficult  to  accomplish,  a  good  strong 
chisel  and  hammer  being  all  that  are  required,  in  addition  to  the 
balling-iron  to  open  the  horse's  mouth.  It  may  not  be  necessary 
to  cast  him,  if  he  is  a  very  quiet  beast,  but  all  operations  on  the 
teeth  and  mouth  are  much  more  easily  performed  when  the  horse 
is  cast.     After  the  projection  has  been  chiselled  off,  all  remaining 


506  DISEASES  AND  INJURIES  OF  THE  FACIAL  EEGION. 

asperities  and  irregularities  are  to  be  smoothed  down  witli  a  line 
file. 

When  the  projecting  piece  of  tooth  is  situated  at  the  back 
of  the  mouth,  it  is  to  be  cut  to  a  level  with  the  other  teeth  with 
a  concave-edged  chisel,  and  separate  guard,  which  may  be  made 
in  a  few  minutes  by  any  smith,  as  it  consists  only  of  a  piece  of 
iron  bent  at  its  extremity  so  as  to  grasp  the  back  of  the  tooth, 
and  of  sufficient  length  in  the  handle  to  protrude  from  the 
mouth.  The  bent  end  is  to  be  inserted  by  the  operator  behind 
the  tooth  ;  the  handle  is  to  be  held  by  an  assistant,  who  is  to 
pull  towards  himself,  exercising  firm  but  not  inordinate  pressure ; 
this  wdll  prevent  the  tooth  from  splitting  when  the  cutting 
chisel  is  struck  with  the  hammer.  In  all  the  other  teeth  but 
the  last,  the  operation  can  be  performed  with  "  Gowing's  sliding 
chisel,"  which  would  be  the  best  instrument  for  the  last  tooth 
also,  if  it  could  be  applied. 


DISEASES  OF  THE  ALVEOLAR  PROCESSES. 

These  are  extensively  diseased,  in  some  cases  wdth  enlarge- 
ment of  the  gums,  which  are  soft,  spongy,  and  bleed  easily.  The 
teeth  may  or  may  not  be  diseased. 

The  causes  are  various,  and  not  easily  demonstrated.  Mr. 
Vamell,  whose  observations  on  diseases  of  the  teeth  and  cranial 
and  facial  regions  are  entitled  to  great  respect,  says : — "  The 
causes  which  give  rise  to  this  condition  of  the  maxillary  bones 
are  not  easy  to  define.  That  a  horse  so  affected  is  from  certain 
pecuharities  predisposed  to  it,  there  can  be  no  doubt.  For 
example,  the  teeth  being  placed  at  a  distance  from  each  other, 
allowing  thereby  the  food  to  accumulate  between  them,  must  be 
looked  upon  as  a  predisposing  cause.  A  strumous  diathesis, 
wdiich  I  believe  to  be  more  common  in  the  horse  than  is  usually 
supposed,  must  also,  when  it  exists,  be  regarded  as  a  predisposing 
cause  of  this  affection.  The  particles  of  food  which  become 
impacted  in  these  unusually  wide  interdental  spaces  after  a  time 
decompose,  and  give  rise  to  foetid  compounds,  which  act  preju- 
dicially upon  the  parts  they  are  in  contact  with.  The  membrane 
wMch  covers  the  gums,  and  also  that  wliich  lines  the  alveoli, 
and  is  reflected  on  to  the  fangs  of  the  teeth,  become  inflamed. 
The  inflammation  w^ill  extend  to  the  bone,  the  blood-vessels  of 


DISEASES  OF  THE  ALVEOLAR  PROCESSES.  507 

which  will  become  enlarged,  as  will  also  the  Haversian  canals 
in  wliich  they  ramify.  The  osseous  laminae  surrounding  these 
canals  will  be  partially  absorbed,  and  to  some  extent  separated 
from  each  other,  and  the  enlarged  spaces  thus  produced  will  be 
hlled  with  inflammatory  exudation.  Hence  the  soft,  spongy  state 
of  the  gums,  their  tendency  to  bleed  from  slight  causes,  and  as 
their  periodontal  membrane  is  separated  from  the  teeth ;  hence 
also  their  looseness  in  the  alveoli." 

Symptoms. — Imperfect  mastication  of  food,  "quidding,"  with 
loss  of  condition ;  the  faeces  containing  much  ill-digested  aliment. 
Examination  of  the  mouth  will  show  to  the  practitioner  that 
there  are  spaces  between  the  teeth  filled  with  hay,  corn,  &c., 
w^hich,  from  long  detention,  may  have  become  foetid. 

Treatment. — The  treatment  recommended  by  Professor  Yamell 
in  those  cases  where  it  is  considered  advisable  not  to  destroy  the 
animal,  is  the  removal  of  the  impacted  matters  from  between 
the  teeth  with  water  and  a  brush  constructed  for  the  purpose ; 
the  parts  to  be  afterwards  washed  out  with  a  solution  of  chloride 
of  hme. 

Very  old  horses  are  subject  to  this  disease  of  the  gums  and 
alveolar  process,  as  well  as  to  looseness  of  the  teeth  in  their 
alveoli  from  natural  decay.  In  such  cases  no  good  can  be  done 
by  any  operation  or  treatment. 

In  addition  to  the  treatment  of  Professor  Varnell,  the  filling 
of  the  interdental  spaces  with  gutta-percha  might  prove  of  great 
service. 

CARIES  OF  THE  TEETH. 

Caries,  dental  gangrene,  or  decay,  is  almost  exclusively  con- 
fined to  the  molar  teeth,  although  I  have  seen  the  incisors  in 
that  condition. 

Caries  of  the  molars  may  commence  primarily  in  the  fang, 
neck,  or  crown  of  the  tooth. 

Caries  of  the  fang  arises  from  inflammation  of  the  pulp,  and 
may  be  caused  by  a  constitutional  predisposition  or  external  in- 
jury. Inflammation  of  the  pulp  does  not  always  cause  caries. 
I  have  several  cases  on  record  where  the  fangs  were  enlarged 
from  periodontal  deposit,  with  abscesses  surrounding  the  fangs, 
without  caries.  Caries  commencing  at  the  fang  may  be  due  to 
obliteration  of  the  pulp  cavity,  at  an  age  when  the  vitahty  of 
the  tooth  depends  upon  the  integrity  of  the  pulp. 


508  DISEASES  AND  INJUEIES  OF  THE  FACIAL  EEGION". 

I  need  scarcely  remind  the  professional  reader  that  the  integrity 
of  the  teeth  depends  upon  a  due  supply,  both  as  to  quantity  and 
quality,  of  nutritive  materials.  On  the  fangs  of  the  recently  cut 
tooth  but  little  crusta-petrosa  is  met  with  compared  with  that 
which  exists  in  old  teeth.  As  ao^e  advances  the  crusta  in- 
creases,  and  the  tooth  grows  from  the  outside. 

In  man,  it  is  generally  agreed  that  after  a  given  time  the  den- 
tine ceases  to  be  produced,  and  the  pulp  becomes  converted  into 
osteodentine.  In  the  horse,  the  pulp  cavity  becomes  obliterated 
gradually  by  the  pulp  continuing  to  form  dentine,  the  pulp  simply 
giving  way  to  its  own  product,  which  ultimately  occupies  its 
place  and  fills  up  its  cavity. 

In  proportion  as  the  pulp  diminishes,  so  is  the  supply  of 
nutriment  to  the  tooth  lessened,  until  at  length  it  is  entirely  cut 
off  from  the  interior ;  and  to  provide  for  the  vitality  of  the  tooth 
under  these  circumstances  the  crusta-petrosa  increases  in  quantity 
on  the  fang,  and  at  the  expense  of  the  perfectly  formed  dentine 
lying  in  immediate  contact  with  its  inner  surface.  That  is  to 
say,  tliis  layer  of  dentine  is  converted  into  crusta-petrosa  by  the 
dentinal  lacunae  undergoing  dilatation,  and  becoming  identicaJ. 
with  the  jioUow  spaces  or  cells  of  the  crusta.  The  tooth  now 
draws  its  nourishment  from  the  blood-vessels  of  the  socket,  and 
thus  it  continues  long  after  the  obliteration  of  its  pulp  cavity  to 
serve  all  purposes  as  a  part  of  the  living  organism.  This  is  the 
natural  condition  of  old  teeth;  but  when  the  pulp  cavity  is 
obliterated  at  an  early  age,  by  a  too  rapid  formation  of  dentine, 
and  consequent  obliteration  of  the  pulp  when  the  crusta  is  not 
yet  sufficiently  developed  to  supply  nourishment  to  the  whole 
tooth,  caries  must  be  the  result. 

Many  cases  of  caries  of  the  teeth  that  have  come  under  my 
observation  have  resulted  from  the  above  cause,  and  very  often 
the  disease  is  confined  to  that  part  of  the  crusta-petrosa  that 
dips  Avith  the  enamel  into  the  interior  of  the  tooth,  splitting 
up  the  tooth  into  several  perpendicular  fragments,  from  crown 
to  fang. 

Caries  of  the  neck  (cervixj  or  the  tooth  is  seen  in  those  horses 
whose  teeth  are  wide  apart,  and  is  caused  by  the  food  remaining 
in  the  interspaces,  and  by  decomposition  exciting  inflammation 
in  the  periodontal  membrane. 

Caries  of  the  neck  is  very  commonly  met  with  in  dogs,  some- 
times causing  abscesses  in  the  cheeks. 


CARIES  OF  THE  TEETH.  509 

Caries  commencing  at  the  crown  or  table  is  due  to  a  portion 
of  the  dentine  losing  its  vitality,  and  the  power  of  resisting  the 
chemical  action  of  the  fluids  of  the  mouth;  a  portion  of  the 
enamel  of  the  crown  may  be  fractured  by  the  animal  accidentally 
biting  a  piece  of  hard  stone  or  metal  contained  in  his  food. 
Mere  fracture  of  the  enamel  is  insutficient  of  itself  to  lead  to 
caries  of  the  teeth  of  the  lower  animals,  for  it  is  a  substance  that 
is  gradually  worn  off  by  the  attrition  of  the  teeth  continually 
going  on  during  mastication;  but  the  pressure  which  has 
been  sufficiently  great  to  cause  fracture  of  the  enamel,  may 
at  the  same  time  have  caused  such  an  amount  of  injury  to 
the  subjacent  dentine  that  it  dies,  and  progressively  becomes 
decomposed. 

In  man  it  seems  there  should  be  death  of  the  dentine  and 
acidity  of  the  oral  fluids  before  caries  can  take  place,  test-paper 
appHed  to  a  carious  tooth  invariably  showing  the  presence  of 
free  acid ;  and  a  very  small  perforation  in  the  enamel  may  co- 
exist with  a  considerable  amount  of  disease  in  the  dentine. 

Mr.  Tomes  thus  describes  the  process  of  destruction  in  the 
teeth,  as  well  as  that  conservative  action  wliich,  as  we  have 
already  seen,  takes  place  in  caries  of  the  bones. 

He  says — "  When  a  portion  of  dentine  has  become  dead,  it 
is  circumscribed  by  the  consolidation  of  the  adjacent  living 
tissue.  The  tubes  become  filled  up,  they  are  rendered  solid, 
and  the  circulation  is  cut  off  from  the  dead  mass  by  the  con- 
solidation of  the  tubes.  This  consolidation  does  not  go  on 
gradually  from  without  inwards,  keeping  in  advance  of  the 
decay,  but  occurs  at  intervals.  It  would  seem  successive  por- 
tions of  dentine  lose  their  vitaHty,  and  that  the  contiguous  living 
tissue  becomes  consolidated."  ^ 

We  thus  see  that  nature  retards  the  progress  of  the  disease  by 
tlu'owiag  barrier  after  barrier  of  defence  against  its  inroads. 

The  act  of  consolidation  is  a  vital  one ;  but,  according  to  Mr. 
Tomes,  it  is  probable  that  the  dentine  thus  consolidated  loses  its 
vitality.  "  This  may  be  inferred  from  the  place  that  it  occupies, 
its  external  protective  position,  its  decreased  capabilities  for 
capillary  circulation,  and  its  increased  density." 

Another  interesting  exhibition  of  vital  action  is  the  production 

*  Dental  Physiology  and  Surgery,  by  John  Tomes,  Surgeon -Dentist  to  the 
Middlesex  HospitaL 


510  DISEASES  AND  INJURIES  OF  THE  FACIAL  REGION. 

of  secondary  dentine,  by  the  surface  of  the  pnlp  under  the  ex- 
citement of  caries  in  the  contiguous  tissue. 

Symptoms  of  caries  of  the  teeth  are  those  of  pain.  The  horse 
so  suffering  will,  whilst  eating,  suddenly  stop  masticating  his 
food,  perhaps  drop  it  from  his  mouth,  will  rest  his  cheek  on  the 
manger,  holding  his  head  to  one  side,  and  after  a  time,  when  the 
pain  subsides,  will  begin  to  feed  again ;  or  he  may  "  quid  "  his 
food,  throwing  out  large  boluses  mixed  with  much  saliva.  I 
have  seen  instances  where  the  mansjer  would  be  half  filled  in 
the  morning  with  semi-masticated  food  and  sour  salivary 
secretions. 

Caries  of  the  fang  will  usually  be  denoted  by  an  enlargement 
on  the  bone  which  contains  it,  corresponding  to  its  position; 
this  enlargement  of  the  bone  may  be  due  to  the  formation  of  an 
alveolar  abscess,  or  to  increased  deposition  of  crusta-petrosa 
(see  Tumours).  Thus  in  the  lower  jaw  the  submaxillary  bone 
will  present  a  prominence  external  to  the  offending  tooth.  This 
bulging  portion  of  the  bone,  when  caused  by  an  alveolar  abscess, 
as  well  as  the  soft  structures  external  to  it,  will  ulcerate,  thus 
giving  exit  to  the  pus. 

Caries  of  the  superior  molars,  when  commencing  at  the 
fang,  is  usually  associated  with  a  discharge  of  foetid  purulent 
matter  from  the  nostril  of  the  side  affected;  this  symptom 
may  be  present  before  those  portions  of  the  tooth  outside  the 
gums  present  any  signs  of  decay.  When  caries  of  the  fang 
attacks  a  first  or  second  superior  molar,  the  superior  maxillary 
bone  will  present  an  enlargement  similar  to  that  already  noticed 
in  the  inferior  maxilla,  with  sometimes  an  ulcer  of  communi- 
cation. 

The  fang  may  be  absorbed  without  suppuration ;  if  such  be 
the  case,  the  tooth  will  sink  below  the  level  of  its  fellows ;  but 
there  will  be  no  external  enlargement,  no  alveolar  abscess,  nor 
ulceration  of  the  bone. 

Mr.  Varnell  says  that  the  irritation  of  the  fangs  may  give  rise 
to  fibro-osseous  tumour,  which  may  either  project  into  the 
antrum,  and  partially  or  wholly  fill  that  cavity,  or  into  the 
mouth,  interfering  thereby  with  the  process  of  mastication. 

Again,  caries  of  the  fangs  may  extend  outwards  to  the 
maxillary  bones,  causing  immense  gaps  of  ulceration  in  them, 
as  shown  in  Photo-lithograph,  Plate  I.,  Fig.  7 ;  or  the  ulcera- 


CARIES  OF  THE  TEETH. 


511 


tion  may  extend  into  the  mouth,  the  pus  discharging  itself 
there,  leaving  an  unhealthy  sinus. 

The  special  symptoms  of  caries  of  the  teeth  may  be  summed 
up,  according  to  M.  Bouley,  in  the  following  order  : — 

Is^.  Eemarkable  foetor,  which  is  peculiar  to  the  disease,  and 
pervading  the  mouth  and  the  secretions  within  it. 

2d.  Flow  of  saliva  from  the  moutli. 

ocl.  Appearance  of  a  black  spot  on  the  carious  tooth,  or  of 
a  cavity  varying  in  extent,  according  to  the  duration  of  the 
disease. 

4:th.  Sharp  pain,  indicated  when  a  tooth  is  struck  by  any 
instrument. 

5th.  Swelling  of  the  gums,  redness,  and  pain  around  the 
diseased  tooth. 

^th.  The  accumulation  of  food  about  the  diseased  tooth,  and 
which,  undergoing  putrefaction,  produces  the  most  repulsive 
smell. 

By  a  careful  examination  of  the  mouth,  the  diseased  tooth 
can  be  detected  by  the  foetor,  and  by  an  accumulation  of 
decomposing  food  around  it,  and  by  an  alteration  in  its  general 
appearance.     The  "  speculum  oris,"  of  which  a  woodcut  is  here 


Fig.  1D9. 


inserted,  is  a  very  useful  instrument  for  examining  the  mouth 
of  the  horse. 

The  treatment  for  diseased  tooth  is  its  removal,  and  this  is 
best  effected  by  trephining  the  alveolus  and  punching  the  tooth 
out. 

All  the  molars,  except  the  last,  may  be  thus  removed.  There 
may  be  some  difficulty  with  the  fifth,  but  the  last  is  so  far 
separated  from  the  outer  wall  of  the  maxillary  sinus,  with  its 
fang  extending  obliquely  upwards  and  backwards  towards  the 


512  DISEASES  AND  INJURIES  OF  THE  FACIAL  REGION. 

inner  plate  of  tlie  orbit,  that  punching  is  rendered  an  impos- 
sibility. I  find,  however,  that  the  fourth  molar  is  more  liable 
to  caries  than  any  of  its  fellows.  This  tooth  is  shorter  and 
thicker  in  its  fang  than  the  others.  Its  fang  is  also  more 
deeply  imbedded  in  the  sinus  than  the  third  and  fifth ;  more 
towards  the  cavity  of  the  nose ;  and  were  it  as  long  as  they,  it 
would  protrude  into  the  nasal  chamber.  It  has  therefore  a  short 
thick  fang,  and  its  pulp  cavities  are  sooner  obliterated  by  a 
deposition  of  dentine.  In  some  five-year-old  mouths,  I  find  its 
pulp  cavities  quite  obliterated. 

The  first,  second,  and  even  third  molars  may  be  withdrawn 
with  the  forceps,  but  they  are  much  more  easily  removed  by 
punching.  The  fourth,  owing  to  the  thickness  of  its  fang,  and 
the  difficulty  experienced  in  fixing  the  forceps  to  a  worn-down 
tooth,  is  only  removeable  by  punching  from  above. 

I  have  operated  in  this  manner  both  upon  the  upper  and 
lower  molars.  The  operation  is  very  simple.  Cast  the  animal, 
and  trephine,  so  as  to  make  the  opening  to  correspond  to  the 
fang  of  the  diseased  tooth,  allowing  sufficient  space  above  or 
below  the  root  of  the  fang — ahove,  if  the  operation  be  in  the 
upper,  and  telow,  if  in  the  lower  jaw — for  the  introduction  of 
the  punch.  The  punch  should  be  at  least  an  inch  in  circum- 
ference at  its  point,  that  it  may  not  cut  or  split  the  tooth. 

Two  or  three  smart,  but  not  heavy,  blows  with  the  hammer 
are  sufficient  to  dislocate  the  tooth ;  and  when  this  is  eff'ected, 
it  may  be  removed  with  the  smaller  molar  forceps,  or  even  by 
the  hand. 

The  after-treatment  is  very  simple,  and  consists  in  frequently 
washing  the  cavity  with  water  containing  a  little  carbolic  acid 
or  chloride  of  lime.  The  elastic  syphon  is  a  very  useful  in- 
strument for  this  purpose,  the  nozzle  being  introduced  into 
the  wound,  and  the  water  forced  into  the  cavity.  In  this 
manner  foreign  matters,  impacted  food,  &c.  are  forced  out  of  the 
sinus. 

It  might  be  supposed  that  an  opening  thus  made  would 
remain  as  a  sinus  of  communication,  but  in  all  my  cases,  where 
the  bones  have  been  healthy,  the  alveolar  cavity  has  become 
obliterated ;  in  the  course  of  about  five  weeks  its  sides  have 
approached  each  other,  and  the  gum  over  them  has  become 
quite  hard. 


CARIES  OF  THE  TEETH.  513 

Some  practitioners  speak  about  stuffing  the  cavity  with  gutta- 
percha. It  is  rarely  necessary;  indeed,  it  is  calculated  to  do 
harm,  by  preventing  the  healing  process,  and  producing  caries 
of  the  bones. 

If  caries  attacks  a  tooth  early  in  the  horse's  life,  the  opposing 
tooth  demands  surgical  attention.  The  carious  tooth  will  sink 
below  the  level  of  the  others  in  the  row,  and  the  opposing 
tooth,  not  being  worn  down  by  the  attrition  of  mastication, 
will  become  elongated;  it  will  grow  to  its  full  length,  and 
project  into  the  hollow  of  the  carious  tooth,  and  eventually 
become  sufficiently  long  to  wear  through  the  gum  and  into  the 
jaw  itself.  The  same  applies  when  the  carious  tooth  has  been 
removed  either  by  disease  or  operation ;  and  a  horse  which  has 
been  subject  to  the  attention  of  the  animal  dentist  for  the  removal 
of  his  teeth  requires  periodical  examination,  the  unopposed  tooth 
requiring  to  be  cut  to  a  level  with  its  fellows  in  the  same  jaw,  and 
occasionally  filed  upon  its  surface,  or  it  will  continue  to  increase 
in  length,  and  be  a  source  of  serious  injury  and  annoyance. 

Quidding  of  the  food  may  exist  unassociated  with  disease  of 
the  teeth.  I  am  of  opinion  that  such  cases  are  due  to  partial 
paralysis  of  the  pharyngeal  muscles. 

Instruments  for  the  treatment  of  the  irregularities  of  the 
teeth  can  be  purchased  from  any  veterinary  instrument  maker. 
They  are  various ;  some  of  them  very  useful,  many  of  them  of 
no  service  at  aH 


DISEASES  OCCURRING  DURING  DENTITION. 

The  three  first  molars  are  temporary  teeth,  and  are  replaced 
by  permanent  ones  in  the  horse  when  he  is  three  and  four 
years  old,  and  in  the  ox  at  two  years  and  six  months  and  two 
years  and  nine  months.  In  young  cattle,  ranging  from  two 
years  old  and  upwards,  the  cutting  of  the  permanent  molar  teeth 
is  occasionally  a  matter  of  some  difficulty,  ov/ing  to  the  unshed 
crowns  of  the  temporary  ones  becoming  entangled  in  the  new 
teeth,  proving  a  source  of  irritation,  and  preventing  the  animal 
from  feeding.  In  some  parts  of  the  country  such  animals  are 
called  "  rotten,"  from  their  emaciated  condition,  and  perhaps 
from  the  feet  or  emanating  from  the  mouth,  arising  from  the 
imprisoned  and  decomposing  food. 

2l 


514  DISEASES  AND  INJURIES  OF  THE  FACIAL  REGION. 

When  an  animal  of  this  age  is  seen  to  stop  feeding,  to  lose 
condition,  or  to  drivel  from  the  mouth,  it  is  necessary  that  the 
mouth  be  duly  examined,  and  if  the  unshed  teeth  are  the  source 
of  irritation,  they  ought  to  he  at  once  removed.  The  smaller 
tooth  forceps  will  be  found  sufficiently  strong.  Many  hundreds 
of  young  cattle  have  been  sacrificed  from  this  cause;  when  a 
proper  examination  has  not  been  made,  they  have  actually  died 
of  starvation  in  the  midst  of  plenty.  In  the  horse  the  same 
condition  of  the  molars  may  occur,  but  it  is  very  unusual ;  the 
corner  incisors,  however,  may  present  the  same  anomalous  con- 
dition ;  the  loosened  crown  of  the  temporary  tooth  grasping  the 
crown  of  the  permanent  one,  which  seems  to  fit  its  irregularities 
sufficiently  tight  to  prevent  its  being  shed  in  the  natural  manner. 
It  must  be  removed,  as  it  proves  a  source  of  irritation.  Horses 
from  four  years  to  four  years  and  six  months  should  have  their 
mouths  occasionally  examined  to  see  if  all  is  going  on  well; 
and  all  3^oung  teething  animals — horses,  cattle,  sheep,  and  dogs 
— if  at  any  time  seen  to  fall  off  in  condition  without  apparent 
cause,  should  undergo  an  inspection  of  their  mouths  in  order  to 
ascertain  the  condition  of  the  teeth. 

Horses  at  four  years  old  are  very  subject  to  a  distressing 
cough.  At  this  age  the  third  temporary  molar  is  replaced  by 
its  permanent  substitute,  and  at  the  same  time  the  sixth  molar, 
or  that  standing  last  in  the  row,  is  being  cut.  Some  amount 
of  irritation  is  seen  to  exist  in  the  gums  during  the  eruption 
of  all  teeth,  but  in  some  instances  the  irritation  is  excessive, 
and  extends  from  the  gum  into  the  fauces  and  larynx.  This  is 
particularly  the  case  with  the  sixth  molar ;  and,  as  a  result  of 
the  extension  of  the  irritation,  cough  is  excited,  more  particularly 
in  the  morning,  when  the  animal  begins  to  feed.  The  cough  is 
loud,  sonorous,  and  prolonged:  the  horse  may  cough  twenty, 
thirty,  or  even  forty  times  without  ceasing.  It  is  a  throat  cough, 
originating  in  laryngeal  irritation,  which  the  animal  endeavours 
to  be  rid  of  by  coughing. 

In  some  instances  the  cough  is  associated  with  a  tendency  to 
diarrhoea,  more  particularly  if  the  animal  is  being  fed  on  un- 
crushed  corn  and  bran.  The  corn,  swallowed  without  being 
properly  masticated,  acts  upon  the  irritable  condition  of  the 
mucous  membrane,  and  easily  sets  up  the  diarrhoea. 

The  cough  is  alarming,  as  it  is  supposed   to  terminate  in 


DISEASES  OCCURRING  DURING  DENTITION,  515 

roaring.  There  is,  liowever,  no  danger  of  that,  if  the  animal  be 
not  predisposed  by  hereditary  taint ;  but  if  he  is  of  a  stock  of 
roarers,  even  the  irritation  of  teething  may  develop  the  infirmity. 
The  treatment  for  tins,  wliich  may  be  truly  called  a  tooth- 
cough,  is  careful  dieting  on  crushed  food ;  hay,  not  much  bran ; 
grass,  if  in  season,  or  roots  when  grass  is  not  obtainable ;  alka- 
line medicines,  more  particularly  the  bicarbonate  of  soda ;  gentle 
aperients  occasionally,  if  the  bowels  be  irregular,  and  if  the  faeces 
are  foetid,  the  foetor  will  be  much  diminished  by  a  few  doses  of 
the  hyposulphite  of  soda ;  the  mouth  to  be  gargled  with  some 
cooling  mixture,  such  as  the  borate  of  soda  or  alum. 

DENTITION  FEVER  (pERCIVALL). 

During  the  active  stages  of  the  process  of  dentition  some 
horses  suffer  from  a  degree  of  constitutional  disturbance,  accom- 
panied by  loss  of  appetite,  debility,  unthriftiness,  a  tendency  to 
diarrhoea,  and  excited  pulse,  but  without  cough  or  any  other 
symptom  indicating  that  the  fever  is  due  to  disease  of  any  internal 
organ.  On  examination  of  the  mouth  being  made,  the  gums  are 
found  red,  swollen,  and  tender,  with  the  secretion  of  saliva  much 
increased.  Hutrel  D'Arboval  says  : — "  A  sort  of  local  fever  ori- 
ginates in  the  alveolar  cavities,  running  high  or  low  according 
to  the  resistance  the  teeth  encounter  from  the  hardness  of  the 
jaws  or  their  own  disproportionate  size  and  solidity.  The  gums 
become  stretched  from  the  pressure  of  the  teeth  against  them ; 
they  dilate,  sometimes  split;  at  the  same  time  they  are  red, 
painful,  and  hot  even  to  a  sense  of  burning.  Internally,  the 
roots  of  the  teeth,  from  shooting  downwards,  compress  the  dental 
nerves,  and  painfully  drag  the  periosteal  linings  of  the  alveolar 
cavities.  These  combined  causes  will  sufficiently  account  for 
the  local  irritation  and  suffering  accompanying  teething,  and 
enable  us  to  explain  many  morbid  phenomena  we  find  appearing 
in  horses  about  this,  from  various  circumstances,  the  most  critical 
period  of  their*  lives." 

Horses  from  three  to  four  years  old  are  more  subject  to  this 
species  of  dental  irritation  than  those  of  a  more  tender  age,  and 
it  is  well  known  amongst  horsemen  that  horses  will  stand  more 
fatigue  at  a  more  tender  age  than  they  wiU  at  tlris ;  and  the 
reason  is  to  be  found  in  the  fact  that  dentition  is  now  at  the 


516  DISEASES  AND  INJURIES  OF  THE  FACIAL  EEGION. 

height  of  its  activity.  When  the  animal  is  three  years  old,eight 
permanent  molars  are  being  cut,  and  four  permanent  incisors  are 
in  active  growth  within  the  gums.  At  four  years  of  age  the 
same  number  of  molars  are  cut,  and  the  same  number  of  incisors 
are  at  a  more  advanced  stage  of  growth  within  the  gums,  in 
addition  to  the  canine  teeth,  w^hich  make  their  appearance  about 
this  time.  'No  wonder,  then,  that  the  eruption  of  so  many  teeth 
is  a  source  of  irritation  and  fever. 

The  best  treatment  is  to  throw  the  animal  off  work,  turn  him 
to  grass  if  the  weather  permits,  or  into  a  loose  box  in  a  well- 
ventilated  spot,  and  give  him  rest  until  the  process  of  dentition 
is  completed.  If  the  gums  are  red  and  swollen,  lancing  them 
will  prove  a  source  of  great  relief.  This  operation  is  easily 
performed  in  the  anterior  portion  of  the  mouth,  but  is  rather 
difficult  at  the  posterior  part ;  however,  it  may  be  done  with  a 
proper  instrument,  the  gum-lancet  of  the  dentist  on  an  extended 
scale  being  the  most  suitable.  If  the  temporary  teeth  seem  to 
hinder  the  eruption  of  their  successors  they  are  to  be  removed. 


SUPERNUMERARY  TEETH. 

Small  supernumerary  teeth  are  often  met  with  in  the  front  of 
the  molars  called  "  woK's  teeth."  They  have  been  supposed  to 
be  a  cause  of  ophthalmia,  but  this  can  scarcely  be.  They  can 
produce  no  inconvenience  ;  but  if  requested  to  extract  them  the 
practitioner  can  hardly  refuse.  The  best  method  is  to  remove 
them  with  the  tooth-forceps. 

The  question  as  to  the  influence  of  the  teeth  upon  diseases  of 
the  eye  might  perhaps  be  deemed  worthy  of  discussion,  inasmuch 
as  the  dental  nerve  is  a  branch  of  the  same  nerve  as  that 
supplying  the  eyes  wdth  common  sensibility,  namely,  the  fifth. 
The  older  writers  maintain  that  moon-bhndness  was  due  to  the 
wolf's  tooth,  and  the  first  procedure  in  the  treatment  was  its 
removal. 

Now-a-days,  however,  the  supposition  is  not  tarried  quite  so 
far,  and  the  utmost  that  can  be  said  is  that  the  irritation  of  teeth- 
ing may  be  an  exciting  cause  of  ophthalmia  in  animals  whose 
constitutions  are  hereditarily  or  otherwise  predisposed  to  the 
disease ;  and  the  removal  of  supernumerary  teeth,  lancing  the 
gums,  or  the  withdrawal  of  offending  teeth,  may  very  possibly  be 
followed  by  some  remission  of  the  ophthalmic  symptoms. 


DISEASES  OF  THE  FACIAL  SINUSES.  517 


DISEASES  OF  THE  FACIAL  SINUSES. 

Tlie  facio-cranial  sinuses  may  very  reasonably  be  looked  upon 
as  one  cavity,  divided  into  frontal,  maxillary,  and  sphenoidal 
compartments.  They  form  air-cavities,  communicating  with  the 
nasal  passages  by  a  small  passage  guarded  by  an  imperfect  valve. 
In  addition  to  the  above  divisions,  each  compartment  is  divided 
into  smaller  cavities  by  thin  osseous  plates,  the  whole  being 
lined  by  a  continuation  of  the  Schneiderian  membrane,  which  is 
neither  so  vascular  nor  so  thick  as  in  the  nasal  passages.  These 
cavities  differ  in  size  in  different  breeds,  as  well  as  in  individual 
horses  of  the  same  breed.  They  are  small  and  ill-developed  in 
all  young  animals,  but  rapidly  increase  in  size  till  full  growth  is 
attained.  In  the  ox  and  sheep  they  communicate  with  the  canals 
and  foramina  of  the  "  horn  processes"  of  the  frontal  bones ;  hence, 
in  the  malignant  catarrhal  fever  of  the  ox  the  horns  are  loosened 
by  the  extensive  suppurative  inflammation  extending  to  the 
cavities  of  the  "  horn  flint." 

In  catarrhal  affections,  the  lining  membrane  of  these  sinuses, 
by  extension  of  the  inflammation  of  the  Schneiderian  membrane, 
becomes  diseased,  and  pours  out  a  quantity  of  pus,  which,  lodging 
in  the  various  compartments  of  the  sinuses,  becomes  a  source  of 
irritation,  constituting  what  is  known  as  "  nasal  gleet  "  or  ozoena. 
A  collection  of  pus  or  tumours  in  the  sinuses,  if  exit  be  not 
allowed,  cause  absorption  of  the  bony  plates  by  pressure. 

Nasal  gleet  may  arise  from  other  causes  than  catarrhal  inflam- 
mation (but  this  is  the  most  common  cause),  such  as  external 
injuries,  caries  of  the  upper  molars,  disease  of  the  superior 
maxilla  from  elongated  inferior  molar  teeth,  alveolar  abscesses, 
hypertrophy  of  the  fangs  of  the^  teeth,  disease  of  the  facial 
bones,  collections  of  inspissated  pus  in  the  convolutions  of  the 
ethmoidal  and  turbinated  bones,  formation  of  cystic  tumours  and  of 
calcareous  concretions  in  the  superior  maxillary  sinuses,  and  from 
clots  of  blood  in  a  state  of  decomposition ;  and  in  horned  cattle 
and  sheep,  from  the  lodgment  of  the  larvae  of  the  QEstrus  bovis. 

General  Syynptoins. — "  In  the  majority  of  instances  there  will 
be  an  irregular  discharge  from  one  nostril,  indicating  that  the 
sinuses  of  that  side  of  the  head  only  are  affected.  This  dis- 
charge will  also  vary  very  much  in  its  quality,  according  to  the 
nature  of  the  malady,  the  duration  of  the  disease,  and  the  struc- 


518  DISEASES  AND  INJUillES  OF  THE  FACIAL  REGION. 

tures  that  may  be  involved.  The  submaxillary  glands  will  be 
tumefied,  but  loose,  in  the  cellular  bed ;  or,  on  the  other  hand, 
hard  and  adherent  to  the  periosteum  of  the  jaw.  The  horse  may 
appear  dull,  but  this  symptom  is  not  always  present ;  the  eye  on 
the  side  of  the  head  aftected  will  look  dim,  the  upper  lid  will 
often  droop  a  little,  and  there  may  be  a  rough  appearance  of  the 
hair  over  the  region  of  the  part  diseased.  The  breath  from  the 
nostril  of  the  side  affected  may  be  offensive,  indicating  thereby 
disease  of  the  bone  or  decomposition  of  the  contained  matter. 
Mastication  may  be  imperfect, — a  defect  which  points  to  the 
teeth.  If  the  malady  is  of  long  standing,  and  the  sinuses  full  of 
matter,  or  the  disease  peculiar  in  its  nature,  there  may  be  a 
slight  enlargement  over  the  affected  sinus ;  or  if  the  disease  be 
of  an  inflammatory  character,  there  will  be  pain,  and  perhaps 
pitting  of  the  part  upon  pressure  ;  and  the  submaxillary  or  tem- 
poral arteries  of  the  side  affected  may  also  throb  more  or  less. 

"  These  symptoms  are  diagnostic  of  disease  of  the  sinuses  of 
tlie  head,  and  are,  I  think,  sufiicient  to  induce  the  practitioner  to 
seek  for  the  precise  cause  which  produced  them." — (Vaenell.) 

When  the  sinuses,  or  a  division  of  them,  are  filled  with  pus, 
percussion,  applied  to  the  outer  walls,  will  cause  a  dull  sound 
to  be  emitted,  and  by  comparing  the  sound  of  the  side  affected 
w^tli  that  of  the  healthy  side,  a  distinction  can  be  draw^n  that 
wall  be  of  material  assistance  to  correct  diagnosis.  In  some  in- 
stances there  will  be  a  bulging  outwards  of  the  bones  over  the 
the  spot  containing  the  pus. 

In  very  doubtful  cases  I  have  been  in  the  habit  of  carefully 
exploring  the  smuses  by  introducing  a  small  gimlet  through  the 
outer  w^all ;  if  pus  be  contained  therein,  the  hollow  of  the  gimlet 
will  be  filled  with  it.  This  wdll  satisfy  the  practitioner  as  to 
whether  there  is  pus  or  not,  but  it  does  not  indicate  the  line  of 
treatment,  as  some  cases  have  done  w^ell  in  my  practice  after 
trepliining,  w^here  no  pus  w^as  contained  in  the  sinuses. 

I  quite  agree  with  Professor  Varnell  that  the  proper  place  for 
trephining  the  sinuses,  in  order  to  remove  anything  abnormal 
that  may  be  contained  in  them,  is  at  their  most  depending  part. 

The  spot  I  always  select  is  situated  about  an  inch  superior 
nnd  posterior  to  the  termination  of  the  zygomatic  spine,  varying 
the  situation  anteriorly,  according  to  the  age  of  the  patient.  If 
he  is  young,  it  must  be  considerably  nearer  to  the  cavity  of  tho 


DISEASES   OF  THE  FACIAL  SINUSES. 


519 


nose,  as  the  fangs  of  the  molar  teeth  are  then  long,  and  their 
alveoli  fill  up  the  sinus,  whereas  in  the  old  horse  the  sinus  will 


Fig.  110. — Skull  cut  open  to  show  the  situation  of  bony  partition  of 
superior  maxillary  sinus.  The  white  circle  is  the  spot  selected  for  tre- 
phining both  cavities  by  one  opening,  a.  Space  between  fourth  and  fifth 
molar  teeth  ;  h,  Termination  of  zygomatic  spine. 

extend  as  low  as  the  zygomatic  crest,  where  the  opening  can  be 
made  without  danger  of  coming  in  contact  with  the  teeth. 

In  some  instances  the  frontal  sinus  has  to  be  opened,  especially 
when  the  contained  pus  is  inspissated,  and  lodged  in  the  convolu- 
tions of  the  ethmoidal  and  turbinated  bones ;  but  in  the  majority 
of  instances  one  opening,  at  the  most  depending  part  of  the  cavity, 
is  sufficient. 

The  external  portion  of  the  maxillary  sinus  is  divided  into 
two  compartments  by  a  transverse  plate,  marked  in  the  drawing, 
which  in  many  cases  is  perfect  throughout  life.  The  superior 
portion  contains  the  alveoli  of  the  two  last  molar  teeth,  the 
inferior  portion  the  alveoli  of  the  third  and  fourth,  while  the 
first  and  second  molars  are  quite  superficially  situated;  very 
often,  indeed,  their  fangs  actually  protrude  through  the  maxil- 
lary bone,  or  they  may  be  so  thinly  covered  by  it  that  they  can 
be  both  seen  and  felt  through  the  skin  of  a  well-bred  horse. 
From  this  short  description  it  will  be  seen  that  the  guide  to  the 
operator  in  making  the  opening  through  the  bone,  so  as  to  em- 
brace both  cavities,  will  be  the  space  between  the  fourth  and  fifth 
molar  teeth.     Of  this  he  must  judge  by  an  inspection  of  the 


520  DISEASES  AND  INJUKIES  OF  THE  FACIAL  REGION. 

mouth,  as  the  teeth  are  not  always  relatively  in  the  same  posi- 
tion as  regards  the  termination  of  the  zygomatic  ridge. 

To  trephine  successfully,  it  is  necessary  to  cast  the  animal. 
I  have  operated  without  casting,  but  the  operation  is  better 
performed  when  the  horse  is  down. 

It  is  advisable  to  remove  a  round  piece  of  the  skin  and  sub- 
cutaneous tissue,  rather  larger  than  the  size  of  the  trephine,  and 
to  dissect  down  to  the  bone  cleanly,  removing  all  shreds  of  the 
soft  structures,  or  the  trepliine  will  become  clogged  with  debris  ; 
and,  to  render  the  operation  less  difficult,  it  is  a  good  plan  to 
bore  a  small  hole  in  the  centre  of  the  piece  of  bone  with  a  small 
simlet,  and  to  introduce  the  centre-bit  of  the  trephine  into  the 
hole  so  bored. 

The  best  kind  of  trephine  is  that  with  a  moveable  centre-bit ; 
but  the  latest  improved  trephines  made  by  Mr.  Mackenzie  being 
very  superior  instruments,  need  no  description. 

AVhen  the  piece  of  bone  is  sawn  through,  it  will,  in  the 
majority  of  instances,  come  out  of  the  aperture  along  with  the 
saw,  or  it  may  fall  into  the  sinus ;  and  when  it  is  attached  to 
the  dividing  ridge  of  the  two  sinuses,  it  may  be  necessary  to 
give  the  trephine  a  slight  twist  to  one  side,  to  disconnect  the 
trephined  portion  from  the  bony  plate. 

The  additional  instruments  are  a  strong  scalpel,  a  pair  of 
forceps,  and  an  elevator,  to  raise  the  piece  of  bone  when  this  is 
not  accomplished  with  the  trephine.  This  elevator,  made  of 
steel,  should  be  six  or  seven  inches  long,  from  half  to  three 
quarters  of  an  inch  wide  at  one  extremity,  which  is  to  be  cir- 
cular, to  correspond  to  the  trephine,  and  sufficiently  thin  to  pass 
into  the  groove  made  by  the  saw. 

Mr.  Yarnell  recommends  that  the  skin  should  be  divided  by 
a  crucial  incision,  and  the  sinuses  explored  by  the  probe.  As 
to  the  crucial  incision,  I  find  that  the  flaps  so  made  are  a 
disadvantage,  interfering  with  the  necessary  daily  washing  and 
dressing  of  the  sinuses  ;  that  they  become  inflamed,  painful,  and 
swollen,  and  cause  the  animal  to  be  restive  when  an  attempt  is 
made  to  dress  the  part ;  and  the  wound  is  also  apt  to  close  too 
quickly  if  its  margins  are  not  destroyed  by  caustic — a  bad 
practice.  In  making  the  circular  incision,  and  removing  the 
whole  of  the  tissues  contained  within  the  circle,  the  operation  is 
more  easily  performed,  the  edges  of  the  wound  do  not  interfere 


DISEASES  OF  THE  FACIAL  SINUSES.  521 

with  the  necessary  ablutions,  and  the  aperture  does  not  close  up 
so  soon. 

I  see  no  advantage  in  using  probes ;  they  are  calculated  to 
wound  and  irritate  the  mucous  membrane,  and  the  contained 
material  can  be  removed  without  them. 

AVith  Professor  Varnell,  I  condemn  the  use  of  setons ;  they  are 
calculated  to  do  harm  by  keeping  up  irritation  in  a  part  where 
it  is  almost  sure  to  lead  to  organic  changes  in  the  bones,  and 
thus  render  what  may  be  a  curable  into  an  incurable  disease. 
Their  insertion  must  originally  have  arisen  from  a  defective 
knowlege  of  anatomy  and  physiology. 

The  opening  into  the  cavity  having  been  made,  the  practi- 
tioner will  be  able  to  judge  as  to  the  nature  of  its  contents.  If 
it  contains  pus,  washing  with  water  will  remove  the  greater 
part  of  it.  Inspissated  pus,  however,  is  very  difi&cult  to  remove, 
and  it  is  not  advisable  to  exercise  too  great  a  force  in  washing 
out  the  sinuses,  as  the  inspissated  contents  will  be  floated  away 
in  a  few  days  by  the  formation  of  new  pus.  Large  flakes  will  thus 
be  carried  off  both  by  the  nostril  and  the  opening.  In  wasliing 
out  the  sinuses,  if  the  horse  be  cast  and  the  nose  elevated,  there 
is  great  danger  of  suffocating  him,  as  the  fluid  will,  in  all  pro- 
bability, find  its  way  into  the  larynx,  and  finally  into  the  lungs. 
Care  must  therefore  be  exercised,  the  water  must  be  injected 
slowly — the  elastic  syphon  is  the  best  instrument  for  this  pur- 
pose— and  the  nose  kept  depressed.  There  is  but  little  danger 
of  this  accident  if  the  patient  be  standing. 

If  the  sinus  contain  anything  abnormal  it  must  be  removed. 
In  one  case  that  I  operated  upon,  there  was  a  large  clot  of  blood, 
in  a  very  foetid  condition,  filling  up  the  whole  cavity.  The  horse 
had  been  discharging  from  the  nostril  for  months;  removal  of  the 
clot,  however,  was  followed  by  a  most  rapid  recovery.  In  other 
cases  calcareous  deposits  will  be  found  studding  the  mucous 
membrane,  as  if  originally  the  tumours  had  been  tubercular, 
and  most  probably  these  concretions  are  calcareous  tubercular 
degenerations. 

The  treatment  of  the  case  after  the  operation  must  depend 
in  a  great  measure  upon  the  cause  of  the  disease,  and  the  state 
of  the  animal's  health.  If  the  cause  be  local,  such  as  a  diseased 
tooth,  blood-clot,  or  imprisonment  of  pus,  and  the  general 
health  good,  but  little  need  be  done,  except  washing  out  the 


o22  DISEASES  AND  INJURIES  OF  THE  FACIAL  REGION. 

sinuses  daily,  first  with  tepid,  then  mth  cold  Avater  containing 
some  deodorizer,  as  the  chloride  of  lime  or  zinc,  carbolic  acid, 
or  Condy's  fluid,  afterwards  with  astringents,  as  weak  solutions 
of  the  perchloride  of  iron,  sulphate  of  copper,  or  tannic  acid. 
The  aperture  must  be  kept  open  so  long  as  the  foetor  and  the 
discharge  continue.  The  discharge  at  first  is  thick,  curdled, 
and  foetid,  but  by  degrees  it  assumes  a  less  unhealthy  character, 
becomes  thinner  daily,  until  at  last  it  has  the  same  appearance 
as  the  nasal  mucus.  This  change  is  always  significant,  and 
diagnostic  that  the  case  will  do  well ;  but  if  the  discharge  con- 
tinue to  have  a  foetid  odour,  to  come  away  intermittingly, 
clotted,  and  sometimes  sanguineous,  the  termination  will  gene- 
rally be  unfavourable.  In  several  instances  I  have  found  some 
portion  of  the  inner  plate  of  the  sinus,  or  one  or  more  of  its 
osseous  irregularities,  divested  of  their  lining  membrane,  and 
presenting  spots  of  caries.  In  such  instances  the  injection  of 
very  dilute  hydro-chloride  acid,  say  one  part  to  a  hundred,  has 
been  of  signal  benefit. 

I  also  find  benefit  to  follow  sprinkling  the  animal's  box  with 
chloride  of  lime;  the  continual  inhalation  of  the  chlorine 
having  apparently  a  beneficial  effect  upon  the  diseased  mucous 
membrane. 

When  the  disease  is  accompanied  by  constitutional  ill  health, 
the  local  must  be  supplemented  by  general  treatment.  I  do 
not  agree  with  those  who  recommend  that  the  general  treat- 
ment should  precede  the  operation,  unless  the  animal  be  in  a 
state  of  extreme  debility.  To  improve  the  tone  of  the  system, 
the  patient  must  be  removed  from  all  depressing  influences,  and 
placed  in  a  well- ventilated  and  comfortable  box  or  stable ;  the 
food  to  be  nutritious,  but  easy  of  digestion ;  the  hay  and  corn 
must  be  of  the  best  quality,  and  given  liberally.  Now  and 
then  a  mash  may  be  allowed, — particularly  if  there  is  any  ten- 
dency to  torpidity  of  the  bowels, — mth  carrots  or  grass,  if  in 
season.  The  horse  is  to  be  well  groomed;  damp  wisping  is 
very  beneficial  by  keeping  up  the  action  of  the  skin ;  the  ex- 
cretory organs  must  not  be  allowed  to  become  dormant,  or  the 
system  will  become  loaded  with  effete  materials. 

Medicinally,  the  mineral  tonics  have  been  found  serviceable, 
particularly  the  sulphates  of  iron  and  copper,  given  in  the  food 
or  in  a  baU. 


DISEASES  OF  THE  FACIAL  SINUSES.  523 

It  is  especially  requisite  to  vary  the  tonics.  Give  the  follow- 
ing for  one  week : — 

Cupri  Sulp.  gii., 

Canth.  pulv.  gr.  v.,  m.,  fiat  bolus, 
and  administer  twice  a  day  after  a  full  meal.  The  ball  may  be 
continued  if  the  case  seems  to  improve,  but  should  it  be  thought 
that  amendment  has  discontinued,  the  salt  of  iron  is  to  be 
substituted  for  the  copper.  A  very  favourite  medicine  of  mine 
is  the  colchicum  powder,  in  addition  to  the  tonics ;  it  acts  un- 
mistakeably  on  the  kidneys,  and  encourages  the  excretion  of  the 
effete  hippurates  and  other  urinary  salts.  Eegular  exercise,  in 
addition  to  the  grooming,  should  be  insisted  upon,  and  it  is 
good  practice  to  order  the  food  to  be  placed  near  the  ground, 
as  movement  of  the  jaws  and  a  depending  position  of  the  head 
favour  the  discharge  of  the  imprisoned  matters. 

There  are  many  diseases  of  the  sinuses  that  result  in  no  per- 
manent improvement  after  operation  and  treatment.  Upon  this 
point  the  observations  of  Professor  Yarnell  are  most  valuable. 
He  says,  in  the  Veterinarian  for  May  1867,  "  Diseases  of  the 
sinuses  of  the  facial  region  of  the  horse's  head,  arising,  as  pre- 
viously stated,  from  external  violence,  are  seldom  treated  suc- 
cessfully, therefore  it  is  not  often  that  a  radical  cure  is  effected. 
Generally  speaking,  the  disease  advances  comparatively  quickly, 
or  it  may  be,  on  the  other  hand,  it  progresses  very  slowly, 
which  will  depend  upon  the  age  and  constitution  of  the  horse, 
and  the  pathological  nature  of  the  malady.  It  is  seldom, 
however,  that  he  is  allowed  to  die  from  the  effects  of  the 
disease  itself,  humanity,  if  not  economy,  suggesting  the  advisa- 
bility of  having  him  destroyed. 

"The  osseous  boundaries  of  the  ^sinuses,  together  with  the 
membraneous  covering,  the  inner  one  in  particular,  become 
thickened  from  being  infiltrated  with  infiammatory  exudation, 
the  blood-vessels  and  Haversian  canals  enlarge,  the  bone  softens, 
and  its  cancelli  become  filled  with  a  semi-gelatinous  or  oily 
material,  the  thickening  of  the  membrane  gradually  increases, 
its  surface  becomes  uneven,  and  when  its  structure  is  examined 
it  will  be  found  to  have  somewhat  of  a  greasy  character.  From 
these  causes  the  sinuses,  which  gradually  become  diminished  in 
capacity,  will,  in  the  process  of  time,  also  become   partly  or 


524  DISEASES  AND  INJURIES  OF  THE  FACIAL  KEGION. 

wholly  filled  with  matter  resembling  porridge,  commingled  with 
small  particles  of  oily  matter. 

"  If  the  practitioner  suspects  these  structures  to  be  in  the 
above  condition,  or  that  the  sinuses  contain  such  materials  as 
I  have  described,  he  will  hesitate  before  he  commences  his 
operation ;  for  if  his  experience  corresponds  with  mine  as  to  the 
result  in  such  cases,  he  will  come  to  the  conclusion  that  they 
are  incurable.  For  my  own  part,  if  I  felt  satisfied  that  the 
pathology  of  the  disease  in  any  case  that  was  presented  to  me 
corresponded  with  the  above  description,  I  should  certainly 
decline  to  have  anything  to  do  with  it  in  the  way  of  treatment ; 
but  as  it  is  difficult  to  diagnose  such  cases  with  any  degree  of 
certainty,  a  prognosis  is  worth  but  little.  Our  investigations, 
therefore,  should  be  extended  beyond  a  mere  surface  examina- 
tion. I  will  suppose  that  the  evidence  is  sufficient  to  convince 
the  practitioner  that  the  sinuses  are  diseased,  but  the  precise 
nature  of  the  affection  he  is  unable  to  determine.  "Wliat  course 
under  such  circumstances  should  be  taken  ?  I  should  advise 
that  one  or  more  of  the  sinuses  be  opened ;  which  can  easily 
be  done  with  a  small  trephine  or  even  with  a  gimlet.  Having 
now  examined  the  walls  of  the  sinuses,  the  lining  membrane, 
and  some  of  the  material  which  they  contain,  he  will  be  prepared 
to  advise  what  course  should  be  adopted.  If  the  character  of 
the  disease  should  turn  out  to  be  simple  in  its  nature,  and  that 
there  is  a  fair  chance  of  its  being  treated  successfully,  he  will 
have  partly  accomplished  the  operation  for  the  cure  thereof;  or 
if,  on  the  contrary,  he  considers  the  affection  to  be  incurable,  he 
will  be  prepared  to  advise  that  the  patient  be  disposed  of  or 
destroyed,  as  may  be  deemed  best. 

"  Disease  of  the  sinuses  is  sometimes  compHcated  with  one  of 
a  similar  character  of  the  nasal  passages ;  indeed,  it  will  be  an 
extension  of  the  affection  from  one  part  to  the  other,  or  it  may 
have  commenced  simultaneously  in  both  cavities. 

"  The  symptoms  indicative  of  the  nasal  passage  as  well  as  the 
sinuses  being  affected  are  as  follows  : — The  discharge,  which  is 
never  very  copious,  is  nevertheless  continuous ;  the  breathing  is 
embarrassed,  particularly  if  the  opposite  nostril  is  closed,  when 
a  considerable  impediment  will  often  be  evinced,  and  percussion 
gives  a  dull  sound  over  the  whole  of  the  side  of  the  face. 

"  If  the  mucous  membrane  of  the  nasal  passages,  v»  hen  thus 


DISEASES  OF  THE  FACIAL  SINUSES.  525 

affected,  be  examined  'post  mortem,  it  will  be  found  much 
thickened  throughout,  but  in  some  places  more  so  than  others ; 
its  structure  will  have  a  somewhat  greasy  appearance,  and  its 
surface  covered  with  a  greyish-yellow,  sticky  fluid,  which,  if 
examined  by  the  microscope,  will  be  found  to  contain  large 
irregular  cells,  granular  matter,  oily  particles,  and  pus  cells,  the 
latter  not  so  abundant  as  from  the  appearance  of  the  fluid 
might  have  been  expected.  The  meatuses  may  be  nearly  closed 
by  the  thickened  membrane,  and  the  spaces  between  the  folds 
of  the  turbinated  bones  entirely  obliterated ;  and  very  often  the 
matter  will  have  accumulated  between  these  folds  to  such  an 
extent  as  to  form  a  considerable  enlargement,  in  fact,  an  abscess, 
which  on  being  opened  will  be  found  to  contain  a  muco-purulent, 
or  a  glairy,  viscous  fluid. 

"  Cases  of  this  kind  have  been  often  mistaken  for  glanders, 
and  horses  destroyed  in  consequence.  This  would  be  an  error 
in  diagnosis,  of  course,  but  a  very  unimportant  one  ;  for  although 
the  disease  is  not,  as  far  as  we  know,  contagious,  nevertheless  it 
is  incurable,  and  if  the  horse's  health  is  impaired  by  bad  keep 
and  exposure,  there  is  a  possibihty  of  its  degenerating  into 
glanders. 

"  I  have  met  with  another  disease  affecting  the  sinuses  of  the 
face  of  the  horse,  dissimilar,  however,  to  the  one  1  have  just 
described.  The  symptoms  which  I  have  observed  to  accompany 
this  affection  are  dulness,  the  eye  on  the  side  affected  is  dim 
and  watery,  and  there  is  a  slight  intermittent  discharge  of  thin 
greyish  matter  from  the  nostril  of  the  same  side.  The  sub- 
maxillary glands  on  this  side  may  also  be  enlarged ;  and  if  so 
they  will  be  hard  and  somewhat  firmly  attached  to  the  periosteum 
of  the  jaw-bone. 

"  If  the  sinuses  be  trephined,  as  recommended  in  the  previous 
affection,  for  the  purpose  of  ascertaining  the  nature  of  the  malady, 
instead  of  the  bone  being  soft  and  much  thickened,  it  will  be 
thicker  than  natural,  and  its  density  much  increased.  The 
mucous  lining  will  also  be  much  thickened — in  some  places 
more  so  than  in  others, — and  it  will  have  the  character  of  a  dense 
fibrous  membrane.  The  sinuses  will  contain  more  or  less  fluid 
of  a  dark  greyish  colour,  which,  when  examined,  will  be  found 
to  contain  large,  irregular,  round  cells,  much  debris  of  broken-up 
cells,  and  some  elongated,  spindle-shaped  cells,  but  no  oily  par- 
ticles or  pus  cells." 


526  DISEASES  AND  INJTTIIIES   OF  THE  FACIAL  REGION. 

Mr.  Varnell  then  relates  an  instance  of  malignant  growths  in 
the  sinuses,  but  the  evidence  brought  forward  is  very  unsatis- 
factory, the  case  to  my  mind  being  one  of  glanders,  although  its 
true  nature  was  rather  obscure. 

In  the  chapter  on  Tumoues  the  reader  will  find  cystic  grow^ths 
in  the  sinuses  described,  also  the  symptoms  and  treatment  of 
nasal  polypi. 

The  dog  is  occasionally  subject  to  ulceration  of  the  nasal  cham- 
bers, and  to  the  formation  of  small  growths  upon  the  mucous 
membrane.  I  cannot  assign  any  causes ;  probably  catarrhal 
affections  may  be  the  originators.  I  have  removed  the  grow^ths, 
and  even  a  portion  of  the  septum  ad  nasum,  wdth  good  effect. 

In  connection  with  the  growth  of  the  face  and  sinuses,  de- 
formities are  apt  to  occur  from  no  ostensible  cause  in  the  form 
of  rounded  enlargements  of  the  maxillary  bones.  The  enlarge- 
ments may  be  confined  to  one  or  they  may  affect  both  cheeks, 
without  discharge  from  the  nostrils,  and  seemingly  causing  no 
inconvenience  to  the  horse.  All  treatment  is  calculated  to  do 
harm ;  therefore,  so  long  as  they  remain  as  mere  deformities, 
the  practitioner  ought  not  to  interfere.  Frictions  with  iodine 
and  blisters,  the  remedies  generally  employed,  very  often  stimu- 
late to  activity  what  otherwise  would  remain  latent. 


NASAL  GLEET 

In  the  horse  frequently  depends  upon  no  traceable  cause,  and 
has  been  variously  named  dropsy  of  the  sinuses  (Vaexell), 
catarrlius  sinuuiii  frontalis  et  raaxillaris  (Gamgee),  and  coryza. 
In  some  cases  there  may  be  a  lodgment  of  pus  in  and  a  discharge 
from  the  sinuses,  wdiile  in  others  the  discharge  is  from  the  nasal 
membrane  only.  The  character  of  the  secretion,  and  the  w^hole 
train  of  symptoms  accompanying  it,  are  very  baffling.  The  horse 
may  be  unthrifty,  with  or  without  cough,  the  coat  harsh,  skin 
dry,  appetite  capricious  or  depraved,  in  some  instances  good, 
]jut  the  assimilative  powders  seem  to  be  at  fault.  The  discharge 
is  intermittent,  bluish-white  in  colour,  resembling  boiled  starch  ; 
sticks  to  the  nostrils,  as  in  glanders,  but  there  is  no  ulceration,  as 
in  that  disease ;  the  Schneiderian  membrane  may  be  excoriated, 
presenting  patches  of  abrasions  resembling  ulcers,  but  not  tlie 
characteristic  pit-like  depression  of  the  glanderous  ulcer.     The 


NASAL  GLEET.  527 

mucous  membrane  is  pale,  perhaps  tliickened  and  infiltrated,  or 
is  of  a  coppery  line ;  and  the  eye  of  the  affected  side  appears 
sunken,  gummy  at  the  lids,  with  a  slight  discharge  of  mucus 
from  its  inner  canthus. 

In  every  case  of  this  kind  the  practitioner  should  be  very 
guarded  in  his  diagnosis,  as  the  disease  may  be  glanders  in  its 
latent  form.  Let  the  animal  be  isolated,  ke23t  in  a  loose  box;  all 
pails,  brushes,  combs,  sponges,  &c.  made  use  of  for  cleaning  and 
feeding  him  must  be  kept  apart  until  time  develops  the  true 
nature  of  the  malady. 

Inoculation  with  the  discharge  is  unsatisfactory,  as  inflam- 
mation and  suppuration  of  the  lymphatics  are  induced  by  any 
vmhealthy  ichorous  discharge. 

Great  improvement  often  results  from  the  effects  of  a  sharp 
fly  blister  to  the  face,  over  the  sinuses  and  nasal  chambers, 
tonics  being  discriminately  administered,  and  the  best  of  food 
allowed.  Injections  of  cold  water  or  some  slight  astringent 
wash,  as  the  tincture  of  the  tercliloride  of  iron,  in  the  proportion 
of  an  ounce  to  the  quart  of  water,  or  of  sulphate  of  copper, 
daily,  are  often  very  beneficial.  Inhalations  of  sulphureous  acid 
gas,  largely  diluted  with  air,  are  useful.  The  gas  is  made  as 
follows : — Burn  half-an-ounce  of  prepared  sulphur — the  milk  of 
sulphur  in  preference,  being  a  pure  preparation — in  a  moderate 
sized  loose  box  or  stable,  and  make  the  animal  inhale  it  for 
half-an-hour  e^^ery  day.  It  has  a  stimulating  and  tonic  effect  on 
the  mucous  membrane,  and  if  sufficiently  dilute,  does  not  irritate. 

A  chronic  nasal  discharge,  with  a  snoring  and  snuffling  sound 
during  breathing,  may  arise  from  some  cause  of  obstruction 
in  the  nostrils — polypi,  or  a  thickening  of  the  Schneiderian 
membrane, — causing  constriction  of  1:he  anterior  nares.  These 
sources  of  obstruction  and  irritation  being  removed,  the  dis- 
charge and  abnormal  sounds  disappear. 


CHAPTER  XXX. 

DISEASES  OF  THE  PHARYNX,   (ESOPHAGUS,  ETC. 

POST-PIIARYNGEAL    ABSCESS PUS    IN    THE    GUTTURAL     POUCHES  — 

PHARYNGEAL      POLYPI CHOKING,      CLINICAL      RECORDS     OF 

(ESOPHAGOTOMY — DILATION  AND  STRICTURE   OP  THE   (ESOPHAGUS 
WIND-SUCKING  AND  CRIB-BITING. 

POST-PHARYNGEAL  ABSCESS 

Is  a  collection  of  pus  situated  in  the  cartilaginous  division  of  the 
guttural  pouches.  Being  placed  between  the  two  cavities,  it 
bulges  into  both,  presses  upon  the  pharynx,  and  interferes  with 
the  act  of  deglutition,  and  as  it  increases  in  bulk,  fills  up  the 
posterior  nares,  draws  up  the  vellum  pendulum  palati,  and  causes 
the  animal  to  breathe  through  the  mouth. 

It  may  be  associated  with  strangles,  or  it  may  appear  inde- 
pendently of  that  disease ;  its  first  symptoms  being  discharge 
from  the  nose,  sore  throat,  difficulty  in  swallowing,  the  food  and 
water  being  returned  through  the  mouth. 

The  pus  being  confined  in  the  tough  cartilaginous  structure  of 
the  guttural  pouches,  prevents  the  abscess  from  bursting  spon- 
taneously ;  it  therefore  becomes  a  necessity  to  open  it  by  opera- 
tion, and  for  this  and  all  operations  within  the  mouth,  the  best 
instrument  is  a  long  straight  bistoury,  enveloped  in  tow  or  lint 
to  within  about  half-an-inch  of  its  point.  This  precaution  having 
been  taken,  the  horse's  mouth  is  to  be  kept  open  by  a  wide  balling- 
iron  ;  one  hand  of  the  operator  is  then  to  be  introduced  into  the 
fauces,  and  by  firm  pressure  he  is  to  find  out  if  there  be  fluctua- 
tion ;  on  this  being  ascertained,  the  bistoury  is  pushed  along  the 
hollow  of  the  hand,  and  plunged  into  the  fluctuating  swelling, 
cutting  neither  to  the  right  nor  left,  for  fear  of  injuring  tlie 
carutids,  but  keeping  the  incision  in  the  centre  of  the  swelling,  a 


POST-PHARYNGEAL  ABSCESS.  529 

gusli  of  pus  will  immediately  escape  into  the  mouth.  I  own 
there  is  some  difficulty  in  the  operation,  but  if  nothing  be  done, 
the  animal's  life  is  sure  to  be  sacrificed. 

The  operation  maybe  performed  through  the  guttural  pouches, 
or  the  puncture  might  be  made  through  the  nostril,  but  I  think 
the  best  way  is  that  through  the  mouth. 


COLLECTIONS  OF  PUS  IX  THE  GUTTURAL  POUCHES 

Differ  from  post-pharyngeal  abscess  by  the  presence  of  more 
or  less  external  swelling;  a  bulging  outwards  of  the  parotid 
glands ;  and  by  an  intermitting  discharge  from  the  nostrils  of 
thick  creamy,  perhaps  slightly  curdled  pus.  The  difficulty  in 
swallowing,  although  at  first  perhaps  very  great,  is  not  persis- 
tent, disappearing  upon  the  cessation  of  the  pharyngeal  inflam- 
mation. 

The  diagnostic  signs  of  pus  in  the  guttural  pouches  are, 
first,  a  discharge  from  either  one  or  both  nostrils  when  the  head 
is  depressed,  or  an  occasional  nasal  discharge,  as  from  an  over- 
flow through  the  openings  of  the  eustachian  tubes ;  a  swelling 
more  or  less  extensive,  without  hardness,  on  the  side  affected, 
with  a  flow  of  pus  from  the  nostril  when  the  swelling  is  pressed 
upon. 

The  Treatment. — Cut  through  the  skin  immediately  behind 
the  posterior  border  of  the  parotid  gland,  above  the  carotids  and 
jugulars,  the  incision  is  to  be  at  least  two  inches  long ;  after  dis- 
secting carefully  through  the  thin  superficial  layer  of  muscular 
tissue,  and  exposing  the  edge  of  the  gland,  the  finger  is  to  be 
introduced  into  the  very  loose  areolar  tissue  situated  beneath  it, 
and  pushed  until  the  wall  of  the  guttural  pouch,  or  envelop- 
ing capsule  of  the  pus  is  felt ;  an  effort  is  now  to  be  made 
for  the  purpose  of  overcoming  it  by  the  pressure  of  the  finger. 
Sometimes  it  will  give  way,  but  if  not,  a  canula  is  to  be  intro- 
duced into  the  space  made  by  the  finger,  through  which  the 
sac  is  to  be  punctured  by  the  stillet,  and  the  whole  cavity 
washed  out  with  warm  water,  forced  in  by  the  elastic  syphon. 
The  wound  must  afterwards  be  kept  open  by  plugs  of  tow, 
and  the  parts  thoroughly  washed  daily  with  water  containing 
carbolic  acid  or  some  astringent,  using  the  syphon  in  order  to  do 
it  effectually. 

2m 


530  DISEASES  OF  THE  PHARYNX,  (ESOPHAGUS,  ETC. 

Mr.  Gamgee  has  described  a  very  formidable  operation,  under 
a  more  formidable  name,  viz.,  Hyo-vertrobrotomy,  for  the  pur- 
pose of  giving  exit  to  pus  in  the  guttural  pouches.  The 
operation  is  quite  unnecessary  ;  and  I  am  surprised  that  any  one 
knowing  the  anatomy  of  the  parts  so  well  as  Mr.  Gamgee, 
should  not  have  thought  of  operating  underneath  the  parotid 
gland.  If  both  pouches  are  filled  with  pus,  the  operation  is  to 
be  performed  on  both  sides. 


PHARYNGEAL  POLYPI. 

Tumours,  with  long  pedicles,  are  sometimes  found  in  the  fauces, 
which  by  faUing  into  the  pharynx  or  larynx  constitute  pharyn- 
geal or  laryngeal  polypi. 

The  symptoms  which  they  produce  are  those  of  choking,  diffi- 
culty of  breathing,  incessant  efforts  to  cough,  and  a  flow  of  saliva 
from  the  mouth.  In  some  instances  "  intermittent  roaring  "  is 
the  only  symptom  of  their  presence. 

They  are  detected  by  examination  of  the  fauces,  and  are  to  be 
removed  by  the  "  ecraseur,"  torsion,  and  when  they  present  a 
broad  base,  they  are  to  be  destroyed,  "  sloughed  out "  by  escha- 
rotics. 

CHOKING. 

Choking  in  the  horse  is  generally  caused  by  the  lodgment  of 
a  quantity  of  dry  food,  such  as  corn,  cut  hay,  or  chaff,  swallowed 
rapidly  by  a  greedy  feeder ;  by  a  piece  of  carrot  or  potato,  or  by 
a  ball  of  large  size  or  hard  consistence,  especially  if  ^vrapped  in 
tliick  coarse  paper,  becoming  lodged  in  the  pharynx  or  oesophagus. 

Eggs  forced  into  the  pharynx  have  often  proved  a  source  of 
obstruction. 

"  Horses  with  voracious  appetites,"  says  Mr.  Percivall,  "  are 
very  apt  in  their  avidity  to  bolt  their  corn  whole,  and  gulp  it 
down  so  rapidly,  that  the  successive  portions,  instead  of  passing 
into  the  stomach,  accumulate  witliin  the  gullet,  and  block  up  its 
canal.  Only  a  small  collection,  or  else  a  large  and  extended  one, 
may  in  this  manner  ensue  before  the  animal  feels  or  expresses 
uneasiness.  All  at  once  he  leaves  off  feeding ;  next,  he  makes 
every  effort  in  his  power  to  complete  his  imperfect  swallow,  and 
gulp  down  the  cause  of  his  distress.     Should  he  not  succeed,  his 


CHOKING.  531 

tliroat  and  neck  become,  through  his  gulping  and  ineffectual 
exertions,  spasmodically  drawn  up  ;  and  probably  he  gives  every 
now  and  then  a  loud  shriek,  no  less  expressive  of  his  own 
anguish  than  excitive  of  the  compassion  of  those  around  him. 
Should  he  attempt  to  swallow  water,  the  fluid,  together  with 
the  saKva  abounding  in  his  mouth,  returns  through  his  nostrils. 
These  urgent  symptoms  are  not,  however,  always  present,  and 
they  depend  very  much  on  the  position  of  the  obstructing  body. 
Thus,  when  it  is  in  the  pharynx,  the  distress,  coughing,  and 
slavering  are  very  urgent.  When  the  obstruction  is  in  the 
cervical  portion,  there  is  a  visible  enlargement  on  the  course  of 
the  oesophagus;  the  general  symptoms  being  great  anxiety  of 
countenance,  sunken  head,  tremors,  and  partial  sweats  over  the 
body,  with  great  exhaustion  shortly  after  the  occurrence  of  the 
accident." 

An  obstacle  lodged  within  the  thoracic  portion  of  the  oesopha- 
gus does  not  give  rise  to  the  more  urgent  symptoms  of  choking ; 
an  animal  may  evince  a  desire  to  drink,  and  may  swallow  water 
until  the  oesophagus  is  filled  from  the  foreign  body  upwards,  and 
which,  distending  the  tube,  causes  violent  attempts  at  vomition. 
In  cattle  and  dogs  the  act  of  vomition  is  very  perfectly  performed, 
but  in  the  horse  the  contents  of  the  oesophagus  are  discharged 
through  the  nostrils,  and  in  lesser  quantities  than  in  other  ani- 
mals. Occasionally,  however,  the  discharge  may  be  through  the 
mouth  as  well  as  the  nose,  and  the  food  may  be  expelled  with 
violence,  and  forced  to  a  sufficient  distance  to  plaster  walls,  rack, 
and  manger. 

In  the  cow  the  obstruction  is  generally  a  piece  of  turnip, 
potato,  leather,  such  as  the  sole  of  an  old  shoe — this  animal 
being  very  fond  of  chewing  any  material  of  the  kind  that  may 
fall  in  her  way.  In  the  dog,  pieces  of  meat,  bones,  pins,  and 
needles,  are  generally  the  causes  of  choking. 

Choking  with  dry  food,  in  the  horse,  especially  in  those  cases 
where  the  whole  length  of  the  oesophagus  has  been  distended,  is 
the  most  dangerous ;  but  I  have  seen  a  most  severe  and  obstinate 
instance  caused  by  an  egg,  given  with  the  beUef  that  an  un- 
IroJcen  egg  was  a  cure  for  the  colic. 

The  symptoms  in  the  cow  are  tympanitis  of  the  rumen,  in- 
voluntary action  of  the  jaws,  flow  of  saliva  from  the  mouth,  and 
a  violent  cough,  causing  forcible  expulsion  of  the  faeces  and  urine. 


532  DISEASES  OF  THE  PHARYNX,  (ESOPHAGUS,  ETC. 

Tympanitis  is  also  occasionally  present  in  tlie  horse.  In  the  dog 
violent  retching  and  cough,  with  staring,  prominent  eyes,  are  the 
most  conspicuous  signs. 

In  some  rare  cases  in  the  horse  the  actual  cause  of  disorder 
may  be  overlooked,  more  especially  when  the  foreign  body  is 
within  the  thoracic  portion  of  the  oesophagus,  and  I  have  seen 
cases  where  loss  of  appetite,  bloodshot  eyes,  constipation,  and 
discharge  of  sahva  from  the  mouth,  were  the  only  apparent 
symptoms,  until  a  more  minute  examination  proved  the  exist- 
ence of  a  swelling  along  the  course  of  the  oesophagus,  on  the 
left  side  of  the  neck. 

Mr.  Gamgee  arranges  the  causes  under  two  heads  :  "  1st.  Those 
dependent  on  the  animal  itseK;  and  2d.  The  nature  of  the  food." 
With  reference  to  those  under  the  first  head,  they  are — "  1st.  Any 
influence  wliich  may  favour  the  contraction  of  the  throat  or 
gullet  on  the  object  swallowed.  2d.  Inflammation  or  ulcera- 
tion of  the  throat  and  gullet,  which  favour  choking.  The  ulcera- 
tion which  follows  bad  accidents  of  this  description,  and  which 
is  especially  troublesome  a  week  after  an  animal  has  been  reheved 
(of  choking),  often  causes  a  dangerous  accumulation  of  alimen- 
tary matters  low  down  in  the  oesophagus,  od.  Organic  disease 
of  the  oesophagus,  especially  constrictions  such  as  are  observed 
in  crib-biting  horses.  Ath.  Injuries  and  diseases  of  the  sahvary 
apparatus  or  organs  of  mastication,  whereby  food  is  imperfectly 
chewed  and  moistened.  If  the  parotid  ducts  in  a  horse  are  both 
opened,  so  as  to  allow  of  the  escape  of  the  secretion,  the  animal 
soon  suffers  from  impaction  of  the  gullet.  5th.  Voracious  appe- 
tite and  rapid  deglutition  of  bulky  or  dry  food." 

The  following  cases  may  be  interesting.  They  are  from  a 
paper  published  in  the  Veterinarian,  by  Mr.  King  of  Stanmore : — 

Mr.  King  observes  that  "choking  is  common  among  old 
horses  whose  grinders  are  imperfect,  and  whose  keen  appetites 
incite  them  to  bolt  their  corn.  He  has  seen  the  oesophagus  in 
this  manner  distended  "  almost  from  the  stomach  to  the  throat " — 
a  case  in  which  recovery  is  very  rare.  Mr.  King's  practice  is  to 
pour  down  fluids,  and  press  and  squeeze  the  oesophagus,  with  a 
view  of  mingling  the  liquid  introduced  among  tlie  masses  of 
corn ;  and  this  manipulation  has  occasionally  succeeded. 

The  following  case  shows  how  much  a  practitioner  may  be 
led  astray  by  false  or  imperfect  accounts  : — 


CHOKING.  533 

Some  years  ago  Mr.  King  was  called  to  a  horse  belonging  to 
a  coach  proprietor.  The  owner  said  his  horse  "  had  a  bad  sore 
throat,  and  could  not  swallow."  Mr.  King  examined  the  throat 
and  gullet,  but,  finding  nothing,  suspected  nothing.  The  horse 
was  blistered  and  drenched ;  but  the  liquids  all  returned  with- 
out any  effort  being  made  to  swallow  them.  The  animal  died  ; 
and  on  examination  there  was  found,  within  the  thoracic  portion 
of  the  oesophagus,  a  ball  composed  of  the  ashes  of  tobacco,  en- 
veloped in  double  paper.  At  first,  all  knowledge  concerning 
this  discovery  was  stoutly  denied ;  but  afterwards  it  was  con- 
fessed that  the  ball  had  been  administered  for  worms.  Had  not 
such  delusion  been  practised,  the  probang  would  have  been  used, 
and,  Mr.  King  thinks,  have  proved  effectual. 

Mr.  King  also  observes,  "  there  is  a  notion  abroad,  new-laid 
eggs  will  improve  the  condition  of  horses ;  and  the  practice  is 
to  administer  them  with  the  shell  only  starred  in  a  few  places : 
a  practice  that  has  in  some  instances  been  the  means  of  choking 
the  animal." 

Mr.  King  was  once  called  to  a  horse  with  a  reported  "  sore 
throat."  The  groom  swore  he  knew  no  cause  for  it.  Mr.  King, 
however,  had  reasons  for  entertaining  doubts  of  the  man's 
veracity,  and  therefore  proceeded  at  once  to  pass  a  probang.  On 
the  return  of  the  instrument  the  bulb  was  found  covered  with 
fragments  of  egg-shell.  The  horse  speedily  recovered.  Mr. 
King  has  had  related  to  him,  on  good  authority,  two  similar 
cases  in  cattle  practice. 

The  following  irremediable  and  fatal  case  of  the  same  descrip- 
tion occurred  to  Mr.  T.  Cooper,  V.S.,  Coleshill. 

In  December  1834  Mr.  Cooper  was  called  to  Dunton  Hall,  to 
a  bay  horse  that  was  taken  suddenly  unwell.  Mr.  Cooper  found 
the  animal  "  coughing  violently,  and  stamping  with  his  fore 
feet,  with  saliva  running  from  his  mouth,  wliich  he  occasionally 
attempted  to  swallow,  but  the  greater  part  returned  through  his 
nostrils."  It  was  evident  there  was  obstruction.  The  horse 
had  been  eating  Swedish  turnips.  Mr.  Cooper  passed  a  whale- 
bone down  the  oesophagus,  "  and  a  rounded  substance  could  be 
distinctly  seen  driven  before  it.  The  horse  after  tliis  appeared 
to  be  relieved ;  he  ate  some  hay  and  drank  some  water,  and  was 
left  for  the  night."  Next  day  he  was  much  worse.  He  did  not 
cough,  but  heaved  very  much  at  the  flank ;  refused  all  food  and 


534  DISEASES  OF  THE  PHARYNX,  OSSOPHAGUS,  ETC. 

drink  ;  was  dejected ;  saliva  with  mucus  ran  from  liis  nose,  and 
much  of  it  he  swallowed.  He  was  bled  ;  took  an  aperient  with 
digitalis  ;  and  his  throat  was  blistered,  from  a  notion  that  "  the 
substance  might  have  injured  his  throat."  Tliird  day,  much 
the  same.  "  Takes  gruel  from  a  bottle,  and  will  not  eat."  Mr. 
C,  from  the  first,  had  no  hope  of  saving  him,  and  early  next 
morning  he  died.  On  dissection,  a  large-sized  hen's  egg,  entirely 
whole,  was  found  firmly  impacted  in  the  oesophagus,  within  a 
few  inches  of  its  cardiac  termination ;  the  parietes  of  the  tube 
around  the  egg  being  "  much  dilated,  and  ulcerated  nearly 
tlu-ough."  The  groom  confessed  he  had  given  the  egg  a  few 
hours  before  Mr.  C.  was  sent  for,  with  a  view  of  improving  the 
horse's  condition.  The  balls  which  had  been  given  must  have 
passed  the  egg  in  a  liquid  state,  probably  along  with  the  gruel. 
—  Veterinarian,  1835. 

Treatment  of  Clwhing. — In  all  cases  where  the  obstruction  is 
at  the  back  of  the  mouth,  or  high  in  the  throat,  and  within 
reach  of  the  operator's  hand,  it  is  to  be  removed  through  the 
mouth.  Wlien  the  impaction  is  in  the  pharynx,  and  barely 
within  reach  of  the  fingers,  its  removal  will  be  rendered  less 
difficult  by  pulling  the  tongue  well  out  of  the  mouth ;  but  if  it 
be  impossible  to  remove  it  thus,  the  object  may  be  pushed  upwards 
by  an  assistant.  Should  the  offending  body  be  sharp-pointed,  it 
will  be  necessary  to  remove  it  by  the  forceps  ;  in  dogs  this  form 
of  choking  will  be  most  commonly  met  with. 

Failing  removal  by  the  mouth,  or  when  the  object  is  too  far 
down  to  be  reached  by  the  hand,  it  should  be  manipulated  on 
the  outside,  and  gently  pushed  upwards  and  downwards  ;  and  if 
it  can  thus  be  made  to  move  either  way  in  the  shghtest  degi^ee, 
its  total  spontaneous  disappearance  may  confidently  be  looked 
for.  Should  this  method,  however,  fail,  the  object  may  be 
removed  by  causing  the  animal  to  swallow  liquids,  more  espe- 
cially demulcents,  such  as  gruel,  or  what  is  better,  an  emulsion 
made  by  mixing  equal  quantities  of  oil  and  water,  blended 
together  by  the  addition  of  a  small  proportion  of  the  carbonate 
of  potash. 

In  choking  ^vith  dry  food,  the  emulsion  must  always  be  used, 
as  the  probang  is  inadmissible,  on  the  ground  that  it  merely  acts 
as  a  ramrod,  and  converts  a  loose  impaction  into  a  hard,  almost 
impermeable,  mass.     In  addition  to  causing  the  animal  to  swal- 


r 


CHOKING.  535 

low  the  demulcent  liquid,  the  mass  within  the  oesophagus  is  to  be 
broken  up  by  gently  rubbing  the  neck,  and  by  pushing  it  upwards 
and  downwards  by  gentle  manipulation.  The  practice  of  having 
-the  throat  rubbed  by  a  strong  broomstick,  worked  upwards  and 
downwards  by  two  powerful  fellows  with  might  and  main,  as  if 
a  horse  were  made  of  iron,  and  not  of  flesh  and  blood,  cannot  be 
too  liighly  censured.  The  manipulation  must  be  directly  over 
the  impaction,  and  ought  to  be  performed  by  the  veterinary 
surgeon's  own  hands. 

In  one  case  of  choking  with  locust  beans,  bran,  and  chaff,  in 
which  the  symptoms  of  distress  were  very  severe,  and  called  for  im- 
mediate relief,  the  following  method  proved  eminently  successful : 
— Water  was  administered  until  the  oesophagus  became  quite  full 
above  the  seat  of  the  impaction.  This  induced  a  violent  fit  of 
coughing ;  the  whole  of  the  fluid  was  thus  forcibly  ejected,  along 
with  some  of  the  impacted  mass.  The  process  was  repeated  after 
short  intervals  of  rest.  Each  fit  of  coughing  brought  up  more 
and  more  of  the  solid  materials  with  the  water  until  the  whole 
mass  was  thus  got  rid  of.  It  may  be  mentioned  that  the  horse 
became  very  restive,  and  fought  against  the  water  being  intro- 
duced through  his  mouth.  I  was  consequently  forced  to  give  it 
by  the  nostrils. 

I  recommend  this  method  where  the  symptoms  demand 
immediate  relief  as  being  safe  and  effectual.  The  water  ought 
to  be  given  by  the  mouth  if  possible,  but  if  this  be  impossible, 
through  the  nostrils,  as  there  is  no  danger  if  carefully  per- 
formed. 

AVlien  the  offending  body  is  a  turnip,  carrot,  egg,  potato,  a 
ball,  or  other  object  that  may  be  removed  with  safety  by  pres- 
sure from  within  the  gullet,  and  wlien  removal  by  manipulation 
and  by  swallowing  liquids  has  failed,  the  probang  must  be 
brought  into  operation. 

Probangs  are  of  various  sizes,  and  may  be  purchased  from  the 
instrument  makers.  I  therefore  need  not  describe  them  further 
than  to  say  that  horses  require  a  smaller  one  than  horned  cattle, 
and  that  a  stillet  with  a  screw  at  the  end  may  be  occasionally 
required.  The  introduction  of  the  probang  into  the  oesophagus 
of  the  horse  is  very  difficult,  and  it  is  generally  necessary  to 
"  cast"  the  animal.  In  the  cow  this  difliculty  is  not  experienced ; 
a  gag  in  the  mouth,  and  two  or  three  strong  fellows  to  hold  the 


536  DISEASES  OF  THE  PHARYNX,  (ESOPHAGUS,  ETC. 

patient,  being  generally  sufficient.     Armatage's  is  the  best  form 
of  gag. 

In  introducing  the  probang,  it  is  essential — 1st,  that  the 
animal's  nose  should  be  elevated,  in  order  to  make  the  mouth 
and  throat  as  near  a  straight  line  as  possible  ;  2d,  that  the  neck 
should  be  kept  straight ;  Sd,  that  the  probang  should  be  pushed 
with  care  over  the  epiglottis  ;  4th,  that  the  pressure  brought  to 
bear  upon  the  obstructing  object  should  not  be  violent,  but  gentle 
and  intermitting,  as  firm  and  persistent  pressure  is  apt  to  cause 
rupture  of  the  oesophagus ;  for  it  must  be  remembered  that 
generally  the  tube  is  spasmodically  closed  beyond  the  obstacle, 
and  severe  and  continuous  pushing  increases  this  condition, 
causes  the  obstacle  to  tear  the  cuticular  coat,  and  finally  to 
penetrate  the  oesophagus  altogether.  If  gentle  taps  with  the 
cup-end  of  the  probang  be  insufficient,  the  "  screw  stillet"  is  to 
be  introduced,  and  an  attempt  made  to  transfix  the  obstacle  with 
the  cork-screw  termination  of  the  stillet,  and  to  withdraw  it 
through  the  mouth.  The  operation  may  be  compared  to  that  of 
drawing  a  cork  out  of  a  bottle ;  but  should  the  operator  fail  in 
removing  the  obstacle  by  this  method,  it  will  be  good  practice  to 
pierce  it  in  several  places  by  the  screw,  and  thus  break  down  its 
integrity,  and  leave  the  completion  of  the  operation  to  its  gradual 
softening,  more  particularly  in  those  instances  where  the  symp- 
toms are  not  very  urgent.  In  cases  where  the  impaction  is 
within  the  thoracic  portion  of  the  oesophagus,  nothing  more  can 
be  done ;  but  should  it  be  within  the  reach  of  the  operator,  it  may 
be  deemed  necessary  to  perform  "  cesophagotomy."  This  opera- 
tion is  very  easily  performed.  It  should  be  adopted,  however, 
as  a  last  resource,  as  wounds  of  the  oesophagus  are  difficult  to 
manage,  and  tend  to  produce  a  stricture  of  the  tube. 

If  the  foreign  body  can  be  distinctly  made  out  by  examination, 
the  operator  should,  in  the  first  place,  have  a  twitch  put  on  the 
horse's  nose — in  the  cow,  the  "  buU  dogs ; "  in  the  second  place, 
the  head  must  be  elevated  and  neck  extended  to  throw  the 
muscles  into  a  state  of  firmness  and  tension ;  then  an  assistant 
is  made  to  press  the  off  side  of  the  neck  upon  the  obstacle,  so  as  to 
cause  it  to  bulge  outwards  as  far  as  possible :  these  preliminaries 
beincr  completed,  the  surgeon  must  make  a  bold  longitudinal 
incision  on  to  the  object,  cutting  through  the  skin,  muscles,  and 
oesophagus  at  one  stroke  of  the  knife,  but  taking  care  not  to 


CHOKING.  537 

make  the  wound  too  large.    If  the  incision  be  not  made  boldly,  the 
animal  will  become  restive,  and  render  the  operation  very  difficult. 

The  offending  body  being  removed,  the  divided  parietes  of 
the  ceso]3hagus  are  to  be  brought  together  by  two  or  three 
sutures,  using  fine  catgut  for  the  purpose  (the  carbolised  catgut 
now  made  use  of  by  surgeons),  and  which,  I  may  mention,  was 
recommended  by  Professor  Dick  at  least  forty  years  ago.  The 
wound  in  the  skin  must  be  closed  with  strong  metallic  suture 
wire,  previously  dipped  in  diluted  carbolic  acid.  In  fact,  every- 
thing must  be  done  to  insure  union  by  the  adhesive  process. 
Pads,  bandages,  and  all  other  remedies  recommended  by 
veterinary  ^Titers,  do  much  harm,  by  irritating  the  wound,  and 
setting  up  the  suppurative  process. 

When  the  wounds  have  been  carefully  closed  by  the  sutures, 
and  when  the  surrounding  parts  have  become  dry,  the  approxi- 
mation of  the  external  lips  may  be  further  strengthened 
by  collodion  or  styptic  colloid,  after  the  application  of  which 
the  parts  must  not  be  touched  for  several  days — until,  in 
fact,  it  is  seen  that  adhesion  has  taken  place.  During  this 
time  the  animal  is  to  be  allowed  a  gallon,  or  as  much  milk 
as  he  will  drink  at  a  time,  three  times  a  day ;  his  head  to  be 
tied  to  the  rack;  and  should  the  milk  escape  through  the 
w^ound — and  this  need  not  occur  if  the  application  of  the 
sutures  has  been  properly  performed — the  oesophagus  is  to  be 
supported  by  the  attendant  applying  a  clean  cloth  to  the  wound 
with  a  gentle  pressure,  so  as  to  prevent  the  separation  of  its  lips ; 
it  is,  however,  better  not  to  do  this  unless  it  is  imperatively 
called  for. 

Mr.  Gamgee  recommends  that  oesophagotomy  should  be  per- 
formed early  in  cases  of  choking-  from  impaction  throughout 
the  whole  length  of  the  gullet,  or,  when  the  obstruction  is 
situated  in  the  horse,  in  its  thoracic  portion.  I  am  of  opinion 
that  he  is  too  hasty  in  his  conclusions,  and  that  everytliing 
should  be  done  to  remove  the  offending  body  in  the  other  ways 
described.  We  are,  however,  indebted  to  Mr.  Gamgee  for  his 
suggestion,  that  when  choking  is  caused  by  an  egg  in  the 
cervical  portion  of  the  oesophagus,  the  egg  should  first  be  pierced 
with  an  exploring  needle,  and  afterwards  crushed  by  a  blow. 

In  concluding  tliis  subject,  I  may  remind  the  reader  that  the 
persistence   of    "  choking "   depends,    first,   on   closing   of  the 


538  DISEASES  OF  THE  PHARYNX,  (ESOPHAGUS,  ETC. 

oesophagus,  immediately  behind  the  seat  of  the  ohstruction,  and, 
secondly,  on  tumefaction,  caused  by  the  irritation  set  up  by  the 
foreign  body.  These  condition?  should  be  borne  in  mind  in 
the  treatment  of  a  difficult  case ;  and  instead  of  ruthlessly 
endeavouring  to  push  the  object  down  with  the  probang,  an 
attempt  should  be  made  to  withdraw  it  with  the  screw ;  and 
1  ailing  this,  the  spasm  of  the  oesophagus  should  be  modified  by 
the  administration  or  subcutaneous  injection  of  morphia  or 
aconite — the  latter  in  preference,  as  it  has  a  direct  influence 
on  the  cardiac  extremity  of  the  oesophagus,  producing  anti- 
jjeristaltic  action  and  attempts  at  vomition. 


DILATATION  AND  STRICTURE  OF  THE  OESOPHAGUS. 

These  two  conditions  are  very  frequently  associated :  for 
example,  if  a  stricture  is  situated  at  any  part  of  the  tube,  all  the 
portions  above  it  become  dilated  from  the  constant  accumulation 
of  ahment. 

I  have  met  with  cases  of  stricture  caused  by  scalding,  by 
tumours  pressing  upon  the  oesophagus,  and  in  one  instance  stric- 
ture of  the  whole  tube  was  found  to  depend  upon  inflammation 
and  thickening  of  its  walls,  the  s}Tnptoms  of  which  prior  to 
dea.th  were — inability  to  swallow,  attempts  at  vomition,  and  the 
presence  of  a  diffuse  swelling  along  the  course  of  the  oesophagus. 
The  subject  of  it  was  a  cow,  and  it  seemed  to  have  arisen  from 
no  traceable  cause.  The  following  case,  published  in  the  Veteri- 
narian for  1830,  by  IVIr.  Cheetham  of  Glasgow,  throws  light  upon 
several  points  connected  with  this  subject : — 

"  Mr.  Cheetham  was  called  to  attend  a  mare  belonging  to  an 
officer  of  the  4th  Dragoon  Guards.  She  discharged  masticated 
food  from  the  nose ;  and  on  the  near  side  of  the  neck  there  was 
a  swelling  in  the  situation  of  the  oesophagus  as  large  as  a  per- 
son's arm,  commencing  about  six  inches  from  the  pliarynx,  and 
gradually  increasing  to  opposite  the  sixth  cervical  vertebra,  and 
there  terminating  abruptly.  There  had  existed  a  partial  obstruc- 
tion for  many  months,  wliich  had  so  increased  of  late,  that  the 
animal  had  been  oblic^ed  to  be  drenched  with  water  to  wash 
down  the  contents  of  the  sac ;  on  other  occasions  a  probang  had 
been  used.  After  such  palliations  as  these,  a  blister  was  applied 
over  the  tumour,  and  she  was  turned  to  grass.     While  there  it 


DILATATION  AND  STRICTUEE  OF  THE  (ESOPHAGUS.  539 

was  observed  that  food  lodged  in  the  sac  of  the  oesophagus  was 
frequently  returned  into  the  mouth,  and  afterwards  re-swallowed, 
and  then  passed  into  the  stomach.  On  being  taken  from  grass, 
a  quantity  of  corn  was  given  to  her,  in  order  to  ascertain  if  the 
stoppage  still  existed.  The  corn  accumulated  the  same  as  before. 
Mr.  C.  determined  on  an  operation.  He  made  an  incision  four 
inches  long  in  the  oesophagus,  opposite  the  sixth  cervical  vertebra. 
The  tube  seemed  divested  of  its  muscular  fibres,  and  was  com- 
posed of  cuticular  coat  alone.  The  contents  of  the  sac  were 
removed,  and  she  was  drenched  with  warm  water  to  wash  out 
the  oesophagus.  The  sac  appeared  three  or  four  inches  in  dia- 
meter ;  but  the  opening  leading  from  it  below  was  so  contracted 
that  it  only  admitted  a  probang  half-an-inch  in  diameter.  After 
the  operation  the  mare  drank  freely  of  warm  water,  which,  by 
applying  pressure  upon  the  wound,  passed  uninterruptedly  into 
the  stomach,  though  without  the  pressure  the  greater  part 
escaped.  She  was  bled,  and  had  an  aperient.  The  wound  was 
fomented,  and  poulticed,  and  dressed;  and  the  mare  partook 
freely  of  gruel.  Some  sloughing  followed,  which  brought  away 
j)art  of  the  oesophagus ;  after  which  the  wound  became  healthy. 
Mr.  C.  now  introduced  a  probang,  of  the  dimensions  of  the  first 
he  used,  through  the  stricture;  which  operation  he  repeated 
twice  or  thrice  a  day  for  ten  successive  days,  with  probangs  of 
larger  size.  Thus  was  the  stricture — which  appeared  to  have 
been  seated  at  the  place  where  the  tube  enters  the  chest — over- 
come ;  and  since  then  the  probang  has  been  occasionally  intro- 
duced by  the  owner  himself.  To  assist  the  mare  in  swallowing, 
the  sac  was  aided  in  its  action  by  pressure,  accomplished  by  a 
broad  breast-plate  furnished  with  a  pad.  The  sac  gradually  grew 
less;  and  the  mare  at  length  became  enabled  to  consume  her 
rations,  and  soon  after  recovered  all  her  life  and  gaiety." 

STRICTURE  OF  CARDIAC  EXTREMITY  OF  (ESOPHAGUS. 

"  The  appearance  of  the  cardiac  stricture  is  this — the  oesopha- 
geal orifice  at  the  stomach  is  contracted  to  the  utmost  degree :  in 
one  of  my  cases,  a  sharp-pointed  instrument  was  with  difficulty 
introduced.  The  muscular  fibres  surrounding  the  strictured  part 
are  prodigiously  augmented  in  volume,  and,  in  addition,  there  is 
a  morbid  thickening  of  their  lining,  arising  from  deposition  into 


540  DISEASES  OF  THE  PHARYNX,  (ESOPHAGUS,  ETC. 

the  cellular  substance  interposed  between  the  muscular  and 
cuticular  coats.  The  cuticular  membrane  is  thrown  into  rugse 
unusually  large,  and  is  evidently  increased  in  substance.  The 
stomach  itself  is  not  affected. 

"  Treatment. — The  two  cases  that  came  under  my  notice  were 
not  unmasked  until  death  had  afforded  the  opportunity  of  inves- 
tigating their  nature,  and  consequently  were  not  submitted  to 
any  specific  or  appropriate  treatment.  Were  I  to  encounter 
another,  I  should  endeavour  to  pass  a  bougie  of  proper  size,  as 
far  as,  or  even  into,  the  stomach,  with  a  view  of  ascertaining  the 
seat  and  nature  of  the  obstruction ;  which,  being  ascertained  to 
be  stricture,  might  possibly  admit  of  dilatation,  or  of  the  con- 
veyance of  caustic  to  it.  Should,  however,  so  long  a  passage  for 
the  bougie  render  it  unavailable  against  the  stricture,  we  must 
do  as  Mr.  Cheetham  has  already  done,  make  an  incision  through 
the  neck  into  the  oesophagus,  and  pass  the  bougie  or  probang 
from  there.  A  cardiac  stricture  would  of  necessity  prove  a  very 
troublesome,  perhaps  an  intractable,  affair ;  one  within  the  neck, 
or  even  the  chest,  might  admit  of  being  overcome." — (Peecivall's 
Hi2^]popatliology. 

Professor  Dick  reports  an  interesting  case  of  dilatation  of  the 
oesophagus. — (See  Veterinary  Pa/pcrs  by  Professor  Dick.)  He 
compares  the  affection  to  globus  hystericus  in  the  human  being. 
This,  however,  is  a  purely  nervous  affection ;  whereas  the  case  in 
question  was  due  to  some  lesion  of  the  oesophagus. 


CPJB-BITERS  AND  WIND-SUCKERS. 

Horses  which  are  crib -biters  or  wind-suckers  are  to  be  con- 
sidered as  unsound,  as  the  vices  generally  arise  from  or  cause 
indigestion,  induce  colic,  tend  to  lower  condition,  and  to  depress 
the  vital  powers. 

A  crih-Mter  seizes  the  manger,  or  some  other  fixture — the 
collar-shank,  when  nothing  else  can  be  taken  hold  of — with 
his  teeth,  arches  his  neck,  and  makes  a  belching  noise.  After 
a  time  the  abdomen  becomes  evidently  enlarged. 

Many  crib-biters  thrive  moderately  well,  whilst  others  are  always 
unthrifty,  dry  in  the  coat,  and  hide -bound.  Some  practitioners 
maintain  that  air  is  swallowed  during  the  act,  whilst  others  state 
that  gases  are  expelled  from  the  stomach,  and  that  the  continued 


CRIB-BITERS   AND  WIND-SUCKERS.  541 

belcliing  or  eructation  causes  further  derangement  of  the  stomach, 
tlie  increased  formation  of  gases,  and  the  consequent  tympanitis. 
I  was  at  first  disposed  to  tliink  that  the  first  opinion  was  the  cor- 
rect one,  as  it  is  quite  possible  for  air  mixed  with  saliva  to  be 
swallowed;  but  further  experience  inclines  me  to  the  latter, 
namely,  that  gases  are  expelled,  and  that  increased  disorder  of 
the  stomach  is  induced  by  the  habit.  A  chronic  crib-biter  may 
be  easily  recognised  by  the  appearance  of  the  incisor  teeth, 
which  are  worn  and  rounded  at  their  anterior  borders,  and  by 
an  enlarged  or  hypertrophied  condition  of  the  muscles  which 
depress  the  jav/,  the  sterno-maxillaris,  stylo-maxillaris,  &c.,  and 
generally  by  the  mark  of  a  strap  on  the  neck. 

A  wind-sucker  smacks  his  lips,  gathers  air  into  his  mouth, 
extends  his  head,  or  presses  it  against  some  solid  body,  arches 
his  neck,  gathers  his  feet  together,  and  undoubtedly  swallows  air, 
blowing  himself  out,  sometimes  to  a  tremendous  extent.  Of  the 
two  vices  this  is  the  worst,  a  wind-sucker  being  more  subject  to 
colic,  indigestion,  and  polyuria  than  a  crib-biter. 

To  prevent  crib-biting,  a  muzzle  or  a  neck-strap  made  for  the 
purpose  is  sold  by  saddlers ;  and  for  wind-sucking  a  strap 
studded  with  sharp  points  of  iron  opposite  the  lower  part  of  the 
jaw,  is  the  best  preventive  ;  w^hilst  the  indigestion  from  wMch 
these  animals  seem  to  suffer  is  best  combated  with  purgatives, 
alkalies,  rock  salt  in  the  manger,  and  regular  work.  Want  of 
work,  indigestion,  and  the  irritation  of  teething  are  generally  the 
causes  of  these  vices. 


CHAPTER  XXXI. 

DISEASES    OF    THE    EYES. 

CONJUNCTIVITIS — NEBULA — ALBUGO STAPHYLOMA ULCERS — GLAU- 
COMA  AMAUROSIS STRABISMUS ECTROPIUM ENTROPIUM 

TRICHIASIS — DISTICHIASIS WARTS WOUNDS HAWS LACHRY- 
MAL   FISTULA STRICTURE PARASITES FUNGUS    II^MATODES 

PERIODIC     OPHTHALMIA CATARACT REMOVAL     OF     EYEBALL 

DISLOCATION   OF   EYEBALL MELANOSIS    OF  HUMOURS EXAMINA- 
TION OF  EYE  BY  CATOPTRIC  TEST  AND  BY  THE  OPHTHALMOSCOPE. 

TRAUMATIC  OPHTHALMIA — SIMPLE  OPHTHALMIA — 
CONJUNCTIVITIS, 

Caused  by  a  blow,  as  tlie  stroke  of  a  whip,  bites  of  insects, 
common  cold,  or  the  lodgment  of  a  foreign  body. 

Inflammation  of  the  superficial  structures  of  the  eye  is  mani- 
fested by  closure  of  the  eyelids,  sw^elling  of  them,  and  increased 
secretion  of  tears,  which  flow  down  the  cheeks,  scalding  the  skin 
to  such  an  extent  that  it  soon  becomes  divested  of  hair  at  every 
part  over  which  the  tears  flow,  and  the  eye  is  retracted  and 
partly  covered  by  the  menibrana  nictitans.  If  the  eyehds  be 
turned  up,  the  conjunctiva  will  be  found  in  a  stfete  of  extreme 
congestion,  and  covered  by  a  number  of  red  streaks.  The  pro- 
gress of  inflammation,  as  seen  in  the  eye,  when  conjunctivitis 
proceeds  perhaps  from  a  simple  catarrhal  affection,  is  very 
instructive.  First  of  all,  there  is  a  slight  weeping,  and  if  one 
may  judge  from  actual  personal  feeling  and  experience,  there  is 
a  sense  of  irritation,  as  if  a  foreign  body  w^ere  in  the  eye.  The 
surface  of  the  cornea  is  dim  and  blue-looking,  and  vascularity  is 
seen  only  at  its  margin  and  the  parts  external  to  it,  because  it 
possesses  no  vessels  in  its  intimate  structure,  and  the  gradually 
increasing  opacity  is  due  to  exudation  (as  already  explained) 
within  its  ultimate  cellular  structure. 


coNJUNCxn^iTis.  543 

If  the  inflammation  be  due  to  external  injury,  the  mark  of 
its  seat  will  generally  be  distinguishable  by  the  greater  intensity 
of  the  opacity  immediately  surrounding  it.  If  it  be  due  to 
contusion  of  the  eyelids,  there  may  be  no  mark  on  the  eye 
itself,  nor  upon  the  eyelids ;  but  generally  these  may  be  seen 
to  present  a  spot  of  ecchymosis  or  congestion,  if  a  careful 
examination  be  made. 

The  question  of  origin  sometimes  becomes  a  matter  of  impor- 
tance, as  a  man's  character  might  be  at  stake,  the  master  perhaps 
blaming  his  servant  for  striking  the  animal's  eye  and  causing 
the  disease.  In  such  instances  the  veterinarian  is  often  appealed 
to  by  both  master  and  servant. 

Treatment. — If  a  foreign  body  is  present  in  the  eye,  it  must 
be  removed.  Should  it  be  a  hay-seed  or  corn-chaff  (a  very 
frequent  cause  of  ophthalmia,  more  especially  in  cattle),  and 
adherent  to  the  coats  of  the  eye,  the  removal  is  often  a  matter 
of  some  difficulty,  requiring  the  use  of  the  forceps  or  a  strong 
feather.  The  removal  of  the-  foreign  body  must  be  performed 
quickly,  as  the  memhrana  nictitans  is  brought  into  powerful 
play  by  the  rapid  retractions  of  the  eye-ball  into  the  socket. 
In  such  instances  it  will  be  found  necessary  to  transfix  the 
memhrana  nictitans  with  a  needle  and  thread,  or  a  strong 
tenaculum,  before  the  irritant  can  be  removed.  After  the  cause 
is  removed,  but  little  treatment  is  required  beyond  warm 
fomentations  and  exclusion  of  light.  In  the  more  severe  cases 
it  may  be  necessary  to  reduce  the  congestion  of  the  vessels  by 
local  bleeding  from  the  angular  vein,  situated  on  the  face, 
immediately  below  the  eye,  or  by  scarifying  the  inner  surface 
of  the  congested  eyelids.  For  my  own  part,  I  think  the  latter 
a  bad  practice,  and  apt  to  increase  the  irritation,  and  I  always 
bleed  from  the  "  angular  vein."  In  addition  to  the  bleeding, 
the  eye  should  be  bathed  with  tepid  water,  or  a  decoction  of 
poppy-heads,  if  the  pain  seem  urgent,  and  covered  over  with 
a  light  piece  of  calico,  properly  adjusted  over  the  ears,  and 
fastened  below  the  cliin.  This  is  to  be  kept  wet  with  a 
decoction  of  poppies,  or  some  anodyne  lotion,  and  the  parts 
bathed  repeatedly  every  day. 

Belladonna,  applied  in  the  form  of  a  soft  extract  externally, 
is  very  useful  in  all  forms  of  ophthalmia.  It  keeps  the  pupil 
dilated,  and  prevents  adhesion  of  the  iris  to  the  lens.     Bella- 


544  DISEASES  OF  THE  EYES. 

donna  and  hyoscyamus  liave  the  same  effect,  but  the  belladonna 
is  the  stronger,  and  is  best  applied,  particularly  if  there  be 
much  irritation,  to  the  eyebrows  and  outside  of  the  eyelids, 
in  the  form  of  a  paste  of  the  consistency  of  honey.  Should 
it,  however,  be  deemed  desirable  to  apply  the  active  principle, 
atrophine,  the  following  solution  may  be  dropped  into  the 
eye  :— 

B.  Atrophige  sulphat.,  gr.  iv. ;  aqua  distil.  |i. 

A  purgative  is  to  be  administered,  and  followed  by  febrifuges 
and  diuretics. 

The  film  that  spreads  over  the  anterior  aspect  of  the  eye 
consists  of  an  exudate,  wliich  continues  so  long  as  the  irritation 
lasts,  but  afterwards  gradually  disappears  by  absorption.  Many 
think  that  it  is  necessary  to  destroy  it  by  caustics,  as  if  it 
were  an  outer  skin  which  had  gTOwn  over  the  eye.  This  is  a 
mistake ;  the  deposit  is  within  the  structures  of  the  cornea  and 
conjunctiva,  and  until  the  inflammation  has  subsided,  all  irritat- 
ing applications  are  calculated  to  do  harm. 

In  simple  ophthalmia,  resulting  from  an  injury  to  the  cornea, 
the  opacity  radiates  from  the  seat  of  injury,  wliilst  in  catarrhal 
inflammation  of  the  eyes  the  opacity  converges  inwards  from 
the  margin  of  the  cornea.  This  form  of  ophthalmia  is  most 
frequently  met  with  in  connection  with  an  epizootic  disease 
which  has  been  termed  "  pink-eye  "  by  horsey  individuals.  It 
is  an  epizootic  inflammation  of  the  areolar  tissue,  and  I  have 
named  it  Epizootic  Celluhtis,  partaking  of  the  nature  of  rheuma- 
tism, and  the  ophthalmic  complication  is  in  all  probabihty  due 
to  the  presence  of  the  rheumatic  poison. 

The  ox,  sheep,  and  dog  are  subject  to  superficial  conjunctivitis 
from  cold  or  other  causes,  the  dog  especially,  as  a  compHcation 
with  "  distemper." 

In  all  these  animals,  as  well  as  in  the  horse,  the  treatment 
is  first  to  subdue  inflammatory  action  by  soothing  remedies; 
and,  secondly,  to  restore  the  tone  of  the  vessels  by  applying 
very  mild  astringent  washes,  as  the  sulphate  of  zinc,  alum,  &c., 
in  water,  and  to  avoid  exposing  the  eye  to  strong  light  until 
it  is  thoroughly  restored. 

NEBULA — ALBUGO. 

A  partial  opacity  remains  after  the  removal  of  the  general 


ALBUGO.  545 

dimness  or  film.  The  opacity  of  tlie  cornea  caused  by  an  injury 
often  remains  as  a  permanent  blemish,  being  due  to  the  presence 
of  reparative  material  in  the  wound,  and  to  a  deposition  of 
lymph  within  the  layers  of  the  cornea  immediately  surround- 
ing it.  An  opacity  of  this  nature  is  at  first  of  a  bluish  tinge, 
and  is  then  called  a  nebula ;  as  it  becomes  older  it  turns  to  a 
pearly-white  colour,  and  is  then  called  an  albugo.  These  terms 
are  quite  conventional,  and  perhaps  objectionable.  The  opacities 
are  in  fact  notliing  more  than  cicatrices,  and  they  undergo 
the  same  changes  as  those  of  other  wounds,  namely,  they 
contract  with  age,  become  firmer  in  their  structure,  but  never 
entirely  disappear. 

Occasional  touches  with  the  solid  nitrate  of  silver,  or  a 
solution  of  it  applied  with  a  camel-hair  pencil,  will  hasten  the 
absorption  of  the  surrounding  lymph.  The  practice  of  blowing 
irritating  matters  through  a  quill  into  the  eye  is  calculated  to 
irritate  the  whole  surface  of  the  conjunctiva,  entail  suffering 
upon  the  animal,  and  do  harm. 

These  opacities  are,  only  when  sufficiently  large,  or  when  so 
situated  as  to  interfere  w^ith  sight,  to  be  regarded  as  causes  of 
unsoundness. 

The  true  Albugo,  or  Leucoma,  is  often  seen  in  dogs,  and  seems 
to  arise  as  spontaneous  spots  of  opacity  on  the  cornea,  without 
previous  inflammation,  and  generally  as  the  result  of  mal- 
nutrition consequent  on  debility  or  disease,  such  as  the  dis- 
temper. Very  young  dogs  are  most  prone  to  them,  especially 
if  improperly  fed,  or  taken  away  from  the  mother  too  soon. 
They  are  best  treated  locally  by  the  solid  nitrate  of  silver, 
carefully  applied,  and  generally  by  good  diet  and  cod-liver  oil. 

Since  Percivall,  Coleman,  and  others  have  passed  away,  writers 
upon  veterinary  surgery  have  described  simple  ophthalmia  as 
if  of  every-day  occurrence;  but  the  fact  is,  it  is  a  very  rare 
thing  to  meet  with  instances  of  it  as  an  idiopathic  disease.  Mr. 
Percivall  says,  writing  in  1826 — "First;  as  it  attacks  the  human 
eye,  it  is  considered  as  a  spontaneous  or  idiopathic  affection,  and 
has  been  so  named — ophthalmitis  idiopathica;  but  the  affection 
in  horses  has,  I  believe  I  may  say  unexceptionally ,  some  apparent 
or  assignable  cause."  Again  the  same  authority  writes,  "In 
regard  to  the  causes  of  common  ophthalmia,  I  have  already 
averred  that  they  are  local,  mostly  apparent,  and  not  constitu- 

2iJ 


546  DISEASES  OF  THE  EYES. 

tional.  Professor  Coleman  and  our  best  modern  veterinary 
writers  all  concur  in  this  etiology;  and  I  may  add,  that  the 
disease  would  never  probably  have  appeared  in  print  in  any 
other  form  had  the  subject  not  fallen  into  hands  that  have 
shown  themselves  unqualified  by  experience  to  pen  any  very 
correct  or  useful  information  about  the  matter."  Evidently  the 
truth  of  Percivall's  observations  seems  to  have  been  overlooked, 
facts  ignored,  and  theories  worked  out,  to  suit  each  man's 
fancy,  and  idiopathic  conjunctivitis  described  as  a  common 
affection. 

STAPHYLOMA, 

A  disease  of  the  eye,  so  named  from  its  being  thought  to 
resemble  a  grape.  In  this  disease  the  cornea  loses  its  trans- 
parency, rises  above  the  level  of  the  eye,  and  even  projects 
beyond  the  eyelids  in  the  form-  of  a  whitish-coloured  tumour, 
which  is  sometimes  smooth  and  sometimes  rough  on  its  surface. 

Staphyloma  is  not  a  rare  disease  amongst  dogs ;  is  occasionally 
seen  in  horned  cattle ;  but  I  have  not  seen  it  in  the  horse  in  its 
true  form,  although  a  spurious  staphyloma  may  sometimes  be 
witnessed  as  a  result  of  an  incision  through  the  cornea  'projgridy 
allowing  the  bulging  outwards  of  the  cornea  elastica. 

Staphyloma,  as  occurring  in  the  dog,  seems  to  arise  from 
two  distinct  pathological  conditions — 1st,  a  growth  of  a  tumour 
of  a  compact,  solid  nature  upon  the  cornea;  2d,  a  bulging  of 
the  cornea,  caused  by  distension  of  the  anterior  chamber  by 
an  increased  secretion  of  its  natural  contents  (dropsy  of  the 
aqueous  chambers).  In  this  form  the  cornea  yields  to  the 
distension  produced  by  the  turgescence  of  the  humours  of  tlie 
eye,  as  the  various  serous  sacs  yield  to  an  accumulation  within 
them. 

In  the  first  form  it  will  very  often  be  found  that  a  small 
ulcerous  excavation  exists  in  the  centre  of  the  tumour,  and 
that  the  tendency  of  this  ulcer  is  to  eat  its  way  through  the 
cornea,  and  destroy  the  eye  by  allowing  the  escape  of  its  con- 
tents. This  form  of  staphyloma  admits  of  considerable  ameho- 
ration.  If  an  ulcer  be  present,  it  should  be  touched  slightly 
with  the  point  of  the  nitrate  of  silver :  this  arrests  the  process  of 
ulceration;  afterwards  the  thickening  can  be  removed  by  excision 
or  by  caustic.     In  dogs  I  have  often  transfixed  the  tumour  with 


STAPHYLOMA.  547 

a  needle  and  thread,  and  have  cut  it  out  with  a  scalpel ;  but 
should  there  be  any  difficulty  in  doing  this,  the  nitrate  of  silver 
or  caustic  potash  may  be  applied  with  freedom.  The  eschar  of 
one  cauterisation  should  be  allowed  to  fall  off,  and  the  effects  to 
subside,  before  the  application  of  the  caustic  is  repeated. 

The  staphyloma  due  to  dropsy  of  the  eye  admits  of  but  one 
remedy,  and  that  may  prove  to  be  only  palliative.  The  cornea 
IS  to  be  punctured,  to  allow  the  escape  of  the  contained  fluids. 
If  this  operation  is  not  performed,  the  cornea  will  in  time  be 
absorbed ;  the  contents  of  the  eyeball  will  then  escape,  and  the 
eye  itself  become  entirely  destroyed.  This  form  of  staphyloma 
is  generally  met  with  in  pet  dogs,  especially  the  King  Charles 
spaniel,  and  is  a  source  of  great  grief  to  their  lady  owners. 
After  the  operation  of  puncturing  the  eyeball,  purgatives  and 
"  short  commons  "  are  to  be  prescribed. 

Ulcers  on  the  cornea  are  best  treated  with  the  nitrate  of 
silver,  either  in  solution  or  in  its  solid  form.  If  there  is  con- 
stitutional disease  or  debility,  the  general  system  must  be 
attended  to. 


DISEASES  OF  THE  HUMOURS  OF  THE  EYE. 

Yery  severe  injuries  to  the  eye  may  cause  the  character  of 
the  aqueous  humour  to  be  entirely  changed.  Instead  of  being 
a  clear,  colourless  liquid,  it  becomes  reddened  with  extrava- 
sated  blood,  milky-white  by  effusion  of  serum,  or  replaced  by  a 
solid  fibrinous  mass,  which,  after  undergoing  various  transforma- 
tions in  colour,  from  bluish-white,  amber,  or  brown,  is  finally 
converted  into  a  pearly- white  material,  partially  or  wholly  filling 
up  the  anterior  chamber,  causing  total  blindness  of  the  eye 
affected,  or  interfering  with  vision  to  a  very  great  extent. 


GLAUCOMA, 

A  disease  in  which  the  vitreous  humour  loses  its  transparency, 
and  assumes  a  blue  colour.  It  is  a  very  uncommon  disease, 
and  is  usually  associated  with  cataract  or  with  amaurosis.  It 
has  been  said  that  in  glaucoma  the  hyaloid  membrane  covering 
the  vitreous  humour  is  absorbed,  and  that  the  humour  is  in  an 
unconfined  fluid  condition.      In  some  dissections  that  I  have 


548  DISEASES  OF  THE  EYES. 

made,  I  have  found  that  the  vitreous  humour  has  heen  converted 
into  a  semi-cartilaginous  or  even  calcareous  mass,  and  that 
instead  of  fluidity  there  was  solidification  of  the  humour  and 
its  membrane.  The  glaucoma  of  old  age  may  occur  without 
previous  inflammation,  and  in  dogs  it  most  commonly  occurs 
in  tliis  way ;  but  in  horses  I  have  always  found  it  associated 
with  some  traces  of  previous  ophthalmia.  The  term  hlue  can 
scarcely  be  applied  to  the  lower  animals,  green  or  bluish-green 
being  more  significant.  Melanosis  of  the  humours  has  been 
observed. 


DISEASES  OF  THE  NERVES  OF  THE  EYE. 

Amaurosis,  as  a  disease  of  the  eye  sui  generis,  is  a  condition 
of  the  optic  nerve  and  its  expansion — the  retina — ^whereby 
they  lose  the  power  of  receiving  and  transmitting  the  impres- 
sions of  objects  to  the  great  nervous  centre,  the  brain. 
Amaurosis  as  a  disease  of  the  optic  nerve  is  incurable,  but  the 
condition  often  exists  as  a  symptom  of  other  diseases,  more 
particularly  of  organic  and  other  lesions  of  the  brain,  the  effects 
of  various  vegetable  and  animal  poisons,  and  of  excessive 
haemorrhage ;  but  it  is  not  my  purpose  to  discuss  these  at  the 
present  time. 

Amaurosis,  gutta  serena,  or  glass  eye,  in  the  horse  presents 
the  following  symptoms : — A  preternaturally  dilated,  round, 
and  motionless  pupil ;  the  eye  lucid  or  glassy  in  aspect ;  the 
eyelids  opened  more  than  natural — ^in  fact,  the  animal  may  be 
said  to  stare.  The  gait  and  the  motion  of  the  ears  are  indica- 
tive of  blindness. 

It  is  possible  to  have  amaurosis  in  one  eye,  but  this  is  very 
rare  in  the  lower  animals,  and  is  generally  indicative  of  brain 
disease.  Amaurosis  with  cataract  is  a  common  termination  of 
constitutional  ophthalmia.  Excessive  haemorrhage  has  produced 
sudden  but  permanent  amaurosis,  both  in  the  horse  and  cow. 
Can  it  be  that,  in  such  instances,  the  paralysis  is  due  to  the 
failure  of  the  circulation  in  the  arteria  centralis  retinae  ?  In 
the  human  subject,  "  amaurosis  is  sometimes  due  to  exhaustion 
of  the  optic  nervous  apparatus,  and  is  often  a  mere  accom- 
paniment of  general  nervous  exhaustion,  arising  from  great  loss 
of  blood,  or  excessive  discharge  of  secretions,"  &c. — (Wharton 
Jones.) 


AMAUEOSIS.  549 

To  d(3tect  the  paralysed  condition  of  tlie  iris  consequent  upon 
the  loss  of  power  in  the  optic  nerve,  all  that  the  practitioner  has 
to  do  is  to  place  the  animal  in  a  strong  light.  If  the  pupil 
remains  round  and  large,  although  the  eye  presents  no  sign  of 
organic  change,  amaurosis  is  present. 

Percivall,  Gamgee,  and  others  recommend  various  remedies  for 
amaurosis.  It  is,  however,  quite  useless  to  expect  any  good 
from  them,  the  affection  being  incurable,  when  not  symptomatic 
of  some  other  disease.  When  it  is  so,  the  treatment  must  be 
directed  to  the  removal  of  its  cause.  In  horned  cattle  amaurosis 
is  present  in  parturient  apoplexy,  hydatids  in  the  brain,  impac- 
tions of  the  stomach ;  in  some  rare  instances,  during  the  latter 
stage  of  haemato- albuminuria,  in  syncope  from  heart  disease  or 
concussion  of  the  brain,  and  during  the  fits  of  megrims. 


STRABISMUS — SQUINTING. 

Irregular  action  of  the  muscles  of  the  eye  never  occurs  in  the 
lower  animals  except  as  a  sign  of  another  disease,  as  indigestion, 
tetanus,  cerebral  meningitis,  acute  ur?emia  or  ursemic  poisoning 
in  the  horse,  and  in  lead-poisoning  both  in  the  horse  and  ox. 


ABNORMAL  POSITION  AND  DISEASES  OF  THE  EYELIDS. 
ECTROPIUM,  OR  EVERSION  OF  THE  EYELIDS. 

The  eyelid  is  drawn  away  from  the  eyeball,  its  conjunctival 
surface  turned  out,  and  its  ciliary  margin  displaced,  downwards 
or  upwards,  according  as  the  lower  or  upper  lid  is  the  seat  of 
the  ectropium.  The  eyeball,  being  thus  deprived  of  the  pro- 
tection of  the  eyelid,  is  exposed  to  constant  irritation,  by  which 
a  chronic  conjunctivitis  is  kept  up,  weakening  the  eye,  and 
giving  rise  to  specks  and  vascularity  of  the  cornea. 

This  is  a  very  rare  condition  of  the  eyelids.  I  have  seen 
only  one  case  of  it  in  the  horse :  it  was  in  the  lower  eyelid,  and 
associated  with  the  opposite  condition — entropium — of  the  upper 
lid. 

In  the  dog  it  is  also  rare  compared  to  entropium,  and  always, 
in  my  experience,  affects  the  lower  lid. 

Treatment. — If  not  very  extensive,  the  conjunctiva  mode- 
rately thickened,  it  may  be  reduced  by  the  nitrate  of  silver. 


550  DISEASES  OF  THE  EYES. 

applied  as  follows: — The  eyelid  being  everted  to  a  greater 
extent,  by  traction  on  tbe  neighbouring  skin,  the  caustic  is  to 
be  pencilled  on  the  conjunctiva  in  a  direction  from  one  angle  of 
the  eye  to  the  other,  parallel  to,  but  at  a  little  distance  from,  the 
margin  of  the  eyelid.  After  the  application  of  the  caustic  the  j)art 
is  to  be  wiped  with  a  bit  of  lint,  and  then  pencilled  with  sweet 
oil.  It  is  often  advantageous  to  scarify  the  conjunctiva  before 
applying  the  caustic.  The  cauterisation  may  be  repeated  in  the 
course  of  three  or  four  days;  and  when  it  is  found  insufiicient 
to  effect  the  desired  object,  it  is  better  to  have  recourse  to  the 
excision  of  an  elliptical-shaped  piece  of  the  thickened  and 
sarcomatous  conjunctiva  parallel  to  the  margin  of  the  eyelid. 

In  the  case  of  the  horse  referred  to,  the  ectropium  being 
large,  excision  was  performed  at  once ;  and  in  order  to  effect 
this  it  became  necessary  to  draw  away  the  lid  from  the  eyeball 
by  traction  on  the  neighbouring  skin ;  the  diseased  conjunctiva 
was  then  pinched-up  with  strong  forceps,  and  the  piece  cut  off 
with  a  sharp  scalpel.  The  piece  removed  must  always  be  of 
such  a  breadth  as  appears  sufficient,  in  order  that  when  the 
cicatrisation  is  complete,  the  contraction  of  the  conjunctiva  may 
neither  be  so  great  as  to  invert  the  eyelid,  nor  so  little  as  still 
to  leave  some  degree  of  eversion.  Further  directions  for  the 
operation,  when  it  appears  necessary  to  modify  the  foregoing, 
may  be  obtained  by  referring  to  Jones'  Ophthalmic  Medicine. 


ENTROPIUM,  OR  INVERSION  OF  THE  EYELIDS. 

This  is  the  converse  of  ectropium ;  the  free  margins  of  the 
eyelid  and  the  eyelashes  are  turned  in  against  the  eyeball, 
which  they  keep  in  a  state  of  great  irritation  by  the  friction 
they  exert  upon  it. 

The  margin  of  the  eyelid  may  be  inverted  in  part  of  its 
extent,  constituting  partial  entropium,  but  more  commonly  the 
entropium  is  total.  One  eyelid  only  may  be  affected,  or  both 
lids  of  one  or  both  eyes. 

Pointer  and  setter  dogs  are  very  frequently  thus  affected; 
the  horse  very  rarely.  The  distress  occasioned  by  the  friction 
of  the  margin  of  the  lid  and  the  eyelashes  against  the  eyeball 
when  an  attempt  is  made  to  use  the  eye,  must  be  very  great. 
There  is  intolerance  to  light,  which  forces  the  animal  to  keep 


ENTROPIUM.  551 

the  eye  closed  to  a  greater  or  lesser  extent.  The  conjunctivse 
become  vascular,  opaque,  thickened,  and  ultimately  dry  and 
cuticular.  There  is  redness  of  the  lids,  with  increased  secre- 
tion of  tears,  and  other  signs  of  conjunctivitis. 

Very  often  entropium  is  congenital,  but  it  may  occur  at  any 
time  of  the  animal's  existence,  from  relaxation  of  the  integu- 
ments of  the  eyelid  and  spasmodic  contraction  of  the  orhicularis 
'palpebrarum  muscle.  Wharton  Jones  says,  "  In  consequence  of 
the  firmness  and  breadth  of  its  tarsal  cartilage,  and  the  existence 
of  the  levator  palpebrse  muscle,  simple  relaxation  of  the  integu- 
ments of  the  upper  eyelid  seldom  produces  any  great  degree  of 
entropium ;  it  merely  hinders  the  eyelid  from  being  freely  raised, 
constituting  one  form  of  ptosis  (falHng  down  of  the  upper  eye- 
lid). It  is  the  lower  eyelid  which  is  most  generally  the  seat  of 
entropium  from  relaxation." 

In  this  form  of  entropium  the  eyelid  is  simply  rolled  back 
upon  itself,  sometimes  so  much  that  the  margin,  with  the 
cilia,  lies  in  the  inferior  palpebral  sinus  of  the  conjunctiva. 
If  the  finger  be  applied  to  the  outside  of  the  eyelid,  and  the 
skin  pressed  down  a  little,  the  margin  of  the  lid  starts  into  its 
place,  and  will  continue  so  of  itself,  so  long  as  the  eye  is 
quiescent,  but  when  the  animal  winks,  it  will  fall  back  with  a 
jerk  into  its  former  state  of  inversion. 

Treatment  consists  in  the  excision  of  a  portion  of  the  relaxed 
integuments.  The  excised  portion  should  be  of  an  elliptical 
shape,  and  of  such  a  breadth,  that  when  the  edges  of  the  wound 
are  brought  together,  the  eyelid  will  be  retained  in  its  proper 
position.  Though  the  piece  of  integument  ought  to  be  re- 
moved from  as  near  as  possible  to  the  margin  of  the  eyelid,  a 
sufficient  breadth  of  skin  must  be  left  at  the  margin  for  the 
insertion  of  stitches. 

After  the  excision  of  the  fold,  the  edges  of  the  wound  are 
to  be  brought  together  by  metallic  sutures,  and  left  without 
further  interference  to  heal  by  the  first  intention. 

I  liave  operated,  and  always  with  success,  upon  a  great 
number  of  dogs  and  a  few  horses. 


TRICHIASIS  AND  DISTICHIASIS. 

Trichiasis  is  a  growing-in  of  the  eyelashes  against  the  eye- 


552  DISEASES  OF  THE  EYES. 

ball,  the  border  of  the  eyelid  remaining  in  its  proper  position, 
which  circumstance  constitutes  the  distinction  between  it  and 
entropium.     Distichiasis  is  the  converse  of  trichiasis. 

Trichiasis  is  of  frequent  occurrence  in  dogs  and  cattle,  but 
seldom  seen  in  the  horse,  and  it  admits  of  being  relieved  only 
by  the  operation  for  entropium. 


WARTS  ON  THE  EYELIDS. 

"Warts  are  not  uncommon  on  the  cutaneous  surface  of  the 
eyelids,  or  on  their  border.  They  are  very  often  of  a  diffused 
encrusted  nature,  and  difficult  to  remove. 

If  pedunculated,  it  is  best  to  remove  them  by  excision  or 
ligature;  if  broad  in  the  base,  strong  acetic  acid  is  the  best 
application. 

WOUNDS  OF  THE  EYELIDS. 

Wounds  of  the  eyelids  are  to  be  treated  upon  conservative 
principles  ;  nothing  must  be  destroyed ;  the  edges  are  to  be 
securely  kept  in  apposition  by  fine  silver  suture  wire. 

The  membrana  niditans  is  occasionally  thickened  by  repeated 
attacks  of  inflammation ;  but  little  can  be  done,  as  it  must  on 
no  account  be  excised ;  serving  as  it  does  instead  of  hands 
to  the  horse  in  the  removal  of  foreign  bodies.  Warts  sometimes 
grow  on  the  membrana  nictitans ;  these  are  to  be  carefully 
excised  with  the  scalpel,  being  first  transfixed  by  means  of  a 
suture,  or  the  tenaculum. 

LACHRYMAL  FISTULA. 

Lychrymal  fistula  is  caused  by  a  blow  fracturing  the  bones 
through  which  the  lachrymal  duct  runs. 

STRICTURE  OF  THE  LACHRYMAL  DUCT. 

This  is  caused  by  thickening  of  its  lining  mucous  membrane ; 
from  catarrh  of  the  nose  extending  into  the  duct,  or  from  the 
specific  inflammation  of  glanders.  The  tears  flow  over  the 
side  of  the  face,  constituting  what  is  termed  "  watery  eye." 


STRICTURE  OF  THE  LACHRYMAL  DUCT.  553 

Watery  eye  may  also  result  from  tumefaction  of  the  eyelids, 
occasioning  not  only  an  increased  secretion  of  tears,  but  a 
diminution  in  the  size  of  the  jfnmcta  laclirymalis,  increased 
secretion  of  tears  from  the  lodgment  of  an  irritant  in  the  eye, 
and  from  a  catarrhal  or  other  inflammation  of  it. 

"  The  common  seat  of  stricture  of  lachr3rnial  duct  appears  to 
be  at  its  superior  part,  and  it  is  best  treated  by  syringing  witli 
cold  water  from  the  puncta  laclirymalis  downwards,  or  it  may  be 
necessary  to  dilate  it  with  a  suitable  bougie." — (Percivall.) 


PARASITES. 

Worm  in  the  eye  is  unknown  in  this  country,  but  is  met 
with  in  India,  and  sometimes  in  Canada.  The  best  account 
of  this  parasitic  disease  that  I  have  seen  is  contained  in  a 
letter  from  Mr.  Charles  Percivall,  dated  June  24th,  1825.'- 
He  says — "  In  low  humid  situations  in  India,  where  fogs  are 
prevalent,  or  where  there  is  stagnant  water,  especially  after  an 
unusually  wet  season,  worm  in  the  eye  is  a  very  common  occur- 
rence. It  is  also  seen  in  other  parts  during  the  cold  months, 
from  the  beginning  of  October  to  the  latter  end  of  February,  and 
particularly  during  the  continuance  of  an  easterly  wind.  The 
symptoms  seem  to  be  conjunctivitis,  the  cornea  obscured  by 
*  nebulous  effusion,'  the  eyehds  closed,  and  intolerance  to  light. 
On  close  inspection  a  small  white  worm  can  be  discerned  float- 
ing in  the  aqueous  humour,  at  one  time  rising  to  the  superior, 
at  another  sinking  to  the  bottom  of  the  chamber." 

The  method  of  treatment  is  by  "  puncturing  the  cornea  at  its 
upper  and  outer  margin,  and  allowing  the  parasite  to  escape  with 
the  aqueous  humour.  This  spot  is^  selected  for  the  operation 
because  the  cornea  is  here  least  dense ;  and  the  upper  instead  of 
the  lower  margin,  because  the  aqueous  humour,  which  gradually 
re-forms,  will  be  less  likely  to  again  escape  whilst  the  wound  is 
healing,  than  if  the  incision  had  been  made  at  the  lower  part." 

The  best  instrument  is  a  sharp-pointed  scalpel,  which  should 
be  pushed  flatwise  through  the  cornea,  as  near  to  its  junction 
with  the  sclerotica  as  possible,  making  an  oblique  opening  under 
the  cornea ;  the  sides  of  the  wound  will  then  fall  into  close  con- 
tact with  each  other,  and  be  in  a  favourable  position  for  uniting 

^  Percivall' s  Lectures  on  the  Veterinary  ArU 


554  DISEASES  OF  THE  EYES. 

by  the  first  intention ;  whereas  if  the  puncture  be  made  directly 
through  the  substance  of  the  cornea,  whether  its  direction  be 
perpendicular  or  horizontal,  the  sides  of  the  wound  will  be  pushed 
apart  when  the  chamber  begins  to  fill,  and  the  healing  process 
retarded. 

I  have  not  seen  special  directions  for  the  operation  by  any 
Indian  veterinary  surgeon  ;  but  having  performed  the  operation 
of  puncturing  the  cornea  for  dropsy  of  the  humours  in  the  dog,  I 
feel  I  am  in  a  position  to  give  preference  to  the  method  just  de- 
scribed. Two  kinds  of  worms  have  been  found  in  the  eye — the 
filaria  oculi  or  filaria  equi,  and  the  strongylus  (strongylus  equinus) 
— and  the  same  kinds  of  worms  are  also  found  in  the  intestines, 
the  areolar  tissue  of  the  loins — supposed  to  produce  the  disease 
called  kummirree — and  in  the  blood-vessels.  The  filarise  are 
small  white  parasites,  about  an  inch  in  length,  of  an  attenuated 
and  cylindrical  form,  having  a  mouth  and  anus,  also  an  intestinal 
canal  suspended  in  a  cavity  of  the  body,  and,  like  other  round 
worms,  the  sexes  are  distinct. 

These  worms  find  their  w^ay  into  the  animal's  body  along  with 
the  water  he  drinks,  either  as  fully  developed  parasites,  or  as  ova 
(eggs).  Both  the  parasites  and  their  eggs  are  abundantly  found 
in  the  stagnant  waters  of  India. 


FUNGUS  H.EMATODES. 

Fungus  hrematodes  consists  of  a  dark-coloured  vascular 
tumour,  growing  within  the  cavity  of  tlie  orbit,  appearing  at 
first  as  a  small  red  spot  at  the  posterior  part  of  the  eye ;  becom- 
ing larger,  it  involves  the  eye  and  the  surrounding  orbital  bones. 
The  tumour  is  malignant  in  its  nature,  being  a  very  vascular 
medullary  cancer ;  so  vascular,  or  so  infiltrated  with  blood,  that 
it  looks  like  a  blood-clot ;  is  of  rapid  growth,  and  if  not  entirely 
removed  by  excision  at  a  very  early  stage,  admits  of  no  cure. 

This  form  of  cancer  is  most  commonly  met  with  in  horned 
cattle ;  but  I  have  repeatedly  seen  it  in  the  horse.  To  remove  it 
with  any  probability  of  success,  the  operation  must  be  performed 
early ;  everything  within  the  orbit  must  be  included  in  the  opera- 
tion, and  the  surface  cauterised  with  the  hot  iron,  not  only  to 
restrain  the  haemorrhage,  but  to  destroy  any  chance  remains  of  the 
mahgnant  gru^vth.    If  the  neighbouring  glands  are  at  all  enlarged, 


FUNGUS  HiEMATODES.  555 

they  also  must  be  removed.  If  the  patient  be  a  cow,  ox,  or  sheep, 
and  if  in  fair  condition,  it  should  be  slaughtered,  as  the  tumour 
tends  to  return  even  if  removed  early,  and  death  is  apt  to  occur 
from  marasmus,  pain,  and  hsemorrhage. 

PERIODIC  OPHTHALMIA. 

Periodic  ophthalmia  is  now  rarely  met  with.  Fifty  years 
ago  thousands  of  horses  became  annually  blind  from  ophthalmia ; 
now-a-days  one  seldom  sees  a  case  of  blindness  from  this 
cause.  This  happy  result  is  due  to  the  enlightened  writings 
of  Coleman  on  ventilation,  and  to  the  advance  of  veterinary 
science — facts  which  the  public  seem  to  ignore. 

It  has  been  variously  termed  "  specific  ophthalmia,"  "  periodic 
ophthalmia,"  or  "  moon-blindness." 

The  term  "  periodic  ophthalmia,"  is  here  retained,  as  it  implies 
the  recurrent  or  intermittent  character  of  the  disease;  but  it 
throws  no  light  upon  the  pathology. 

Periodic  ophthalmia  is  a  constitutional  affection — cachectic  or 
diathetic,  probably  rheumatic — arising  from  some  cause  opera- 
ting primarily  on  the  constitution,  and  secondarily  on  the  organ 
of  vision,  terminating  in  an  opacity  of  the  crystalline  lens, 
termed  cataract. 

Symptoms. — The  attack  generally  comes  on  suddenly,  without 
ostensible  cause,  and  in  the  night.  The  eye  presents  signs  of 
weakness,  the  upper  lid  droops,  the  eye  seems  smaller  than 
its  fellow,  it  is  drawn  into  the  orbit  by  the  retractor  muscle ; 
removed,  as  it  were,  as  far  as  possible  from  the  light,  which, 
from  its  sensitiveness,  it  cannot  bear:  intolerance  to  light  is 
also  manifested  by  repeated  rapid  nictitations,  and  by  recoil  of 
the  globe  within  the  orbit.  This  is  especially  evinced  when  a 
strong  light  is  suddenly  brought  to  bear  on  the  eye — and  it  is 
further  protected  by  the  drooping  of  the  lids,  its  natural  curtain ; 
the  membrana  nictitans  projects ;  the  tears  flow  over  the  lower 
lid  and  bedew  the  face.  When  the  eye  is  more  closely  in- 
spected, the  cornea  is  dull;  the  dulness,  at  first  most  intense  at 
its  margin,  but  soon  spreading  over  its  surface,  rendering  a  view 
of  the  interior  structure  of  the  eye  an  impossibility.  The 
dulness  is  inclined  to  an  amber  colour ;  and  it  was  maintained 
by  Professor  Dick  that  this  was  due  to  the  fulness  and  pressure 


556  ^  DISEASES  OF  THE  EYES. 

of  the  parts  behind  the  cornea,  and,  says  the  Professor,  "  Were 
that  once  relieved,  the  cornea  would  immediately  regain  its 
transparency." — (Dick's  Manual  of  Veterinary  Science)  I  think, 
however,  that  an  impartial  investigation  of  the  matter  will  prove 
that  the  opacity  is  due  to  the  cornea  being  involved  in  the 
inflammation. 

Percivall,  describing  the  opacity  of  the  cornea  and  anterior 
chamber,  says — "  At  the  beginning,  the  anterior  chamber  pre- 
serves its  pellucidity,  so  that  the  iris  and  pupil  can  be  seen,  the 
latter  contracted,  the  former  unchanged  in  colour ;  in  the  course 
of  two  or  three  days,  sometimes  earlier,  the  chamber  becomes 
obscured  by  a  dingy- white  or  amber- coloured  deposit  floating 
within  it,  through  which  the  pupil  is  hardly  discernible,  con- 
tracted, and  looking  much  like  the  black  eye  of  a  garden  bean." 
The  opacity  of  the  cornea  proceeds  from  its  circumference  to  its 
centre,  until  at  last  the  whole  of  its  surface  becomes  of  a  dull 
greyish  hue,  and  in  some  cases  blood-vessels  are  seen  ramifying 
over  it.  When  the  dulness  is  great,  the  iris  is  invisible,  but 
when  it  can  be  seen,  it  will  be  found  that  the  pupil  is  narrow 
and  contracted,  the  eye  altogether  presenting  evidence  of  intol- 
erance to  light.  In  some  instances  direct  evidence  of  iritis  can 
be  distinguished  early  in  the  disease,  the  iris  being  of  a  dead 
amber  colour  from  a  deposit  of  lymph  on  its  surface,  as  well  as 
upon  the  corpora  nigra. 

Some  writers  are  inclined  to  give  preference  to  some  one 
particular  structure  of  the  eye  as  the  seat  of  the  disease.  I  am 
of  opinion  that  it  may  be  considered  as  panophthalmitis,  or 
inflammation  of  the  whole  eye,  commencing  primarily  as  "  oph- 
thalmia interna  posterior." 

The  remaining  symptoms  are  turbidity  of  the  aqueous  humour ; 
the  corpora  nigra  lose  their  jetty  blackness  ;  the  pupil  becomes 
more  and  more  contracted;  the  conjunctiva  intensely  reddened; 
and  in  some  cases  the  vessels  crowd  around  the  margins  of  the 
cornea,  across  which  numbers  of  them  shoot  in  irregular  lines ; 
occasionally  pus  forms  in  the  anterior  chamber  (hyopyon) ;  and 
in  rare  instances  the  inflammation  may  terminate  in  suppuration 
of  the  entire  coats,  and  consequent  disruption  of  their  contents, 
but  the  common  termination  is  cataract. 

The  inflammation  is  apt  to  move  from  one  eye  to  the  other, 
and  for  this  reason,  and  on  account  of  its  recurrent  nature,  the 
disease  has  been  described  as  "  gouty  ophthahnia." 


PERIODIC  OPHTHALMIA.  557 

The  subsidence  of  the  attack  is  marked  by  a  diminution  of 
the  inflammatory  symptoms,  the  haziness  slowly  disappears  from 
the  cornea,  the  pupil  becomes  larger,  less  contracted,  rounder, 
disclosing  the  lens  altered  to  a  hazy  grey  colour,  the  result  of 
change  in  its  substance,  or  a  deposit  on  its  surface,  the  prelude 
to  cataract ;  the  pupil  in  many  instances  does  not  regain  its 
former  dimensions,  even  after  a  first  attack,  the  iris  having 
become  fixed  by  adhesion ;  the  cornea  may  regain  its  natural 
hue,  but  the  iris  is  more  or  less  permanently  altered  in  aspect 
and  colour,  and  the  eye  seems  smaller  than  natural:  this  is 
caused  by  its  continuing  in  an  irritable  condition,  and  its 
being  drawn  backwards  by  the  retractor  muscle,  even  after  the 
apparent  subsidence  of  the  disease.  As  time  advances,  the 
opacity  of  the  various  structures  becomes  less  apparent;  but 
sometimes  the  cornea  is  clouded  by  an  interlaminal  deposit,  and 
generally  the  eyebrow  remains  in  a  peculiarly  wrinkled  condi- 
tion. This  wrinkled  appearance  of  the  eyebrow  after  the  acute 
symptoms  have  passed  off,  is  characteristic  of  periodic  ophthalmia. 
The  eye,  having  regained  more  or  less  of  its  natural  appearance, 
may  remain  free  from  active  disease  for  an  indefinite  period. 
In  some  instances  the  disappearance  of  the  acute  symptoms  may 
go  on  satisfactorily  for  three  or  four  days,  when,  without  any 
appreciable  cause,  the  eye  is  again  found  highly  inflamed,  the 
eyelids  closed,  and  the  animal  seemingly  suffering  intense  pain ; 
whilst  in  other  instances  the  active  signs  of  the  disease  totally 
disappear  for  several  weeks  or  months,  and  then  recur  again  and 
again,  until  cataract  is  fully  developed ;  other  cases  are  marked 
by  complete  subsidence  of  the  disease  in  one  eye,  and  its  appear- 
ance in  the  other;  its  mode  of  procedure  in  such  cases  is  to 
attack  one  eye,  then  the  other,  until  both  are  permanently 
altered  in  structure,  and  the  animal  is  left  totally  blind. 

Ordinarily,  bhndness  and  complete  disorganization  are  fol- 
lowed by  a  cessation  of  the  paroxysms ;  but  there  are  exceptions 
to  this,  and  I  have  met  with  cases  where  acute  inflammation 
has  recurred  periodically  for  years  after  a  cataract  has  been  fully 
developed. 

It  is  quite  possible  that  one  attack  may  disorganize  the  organ 
to  such  an  extent  as  to  cause  it  to  assume  the  appearance  of  a 
bulbous  mass,  the  iris  driven  into  the  aqueous  chamber,  adherent 
to   the   cornea ;   the   lens   dislocated ;   and   all   the   structures, 


558  DISEASES  OF  THE  EYES. 

including  even  tlie  vitreous  humour,  so  cemented  together  that 
scarcely  a  vestige  of  the  original  appearance  of  the  eye  is  dis- 
cernible. These  instances  are,  however,  rare,  and  mark  the 
severity  of  the  inflammation ;  the  majority  of  cases  being  of  a 
much  milder  type,  recurring  and  finally  ending  in  cataract,  ossi- 
fication of  the  choroid,  retina,  and  the  whole  contents  of  the 
chambers. 

The  late  Professor  Coleman,  from  very  extensive  observations 
made  at  a  time  when  this  disease  was  exceedingly  prevalent, 
arrived  at  the  conclusion  that  the  affection  resulted  from  the 
same  conditions  as  those  which  engendered  glanders  and  farcy, 
namely,  contaminated  atmosphere,  resulting  from  ill-paved,  ill- 
drained,  unventilated  stables ;  and  Mr.  Percivall,  in  discussing 
the  subject,  after  adducing  evidence  that  mules  and  asses  were 
quite  as  subject  as  horses  to  ophthalmia  during  the  Peninsular 
war,  says — "  Shall  we  say,  by  way  of  a  summary  rationale,  that 
the  effluvia  arising  from  the  breath,  perspiration,  urine,  dung, 
&c.,  generate  an  animal  poison,  and  that  this,  being  in  a  gaseous 
form,  is  diffused  through  the  atmosphere  of  the  stable,  and  with 
it  carried  into  the  system  through  the  medium  of  the  air-pas- 
sages, skin,  or  alimentary  canal — most  likely  by  the  first,  but 
possibly  by  one  of  them — wherein  it  breeds  disease  in 
the  circulating  fluids,  which  breaks  out,  under  a  local  form,  in 
the  lungs,  skin,  nose,  eyes,  &c.  ?  Or  shall  we  say  that  these  parts 
are  affected  locally  in  the  first  instance,  and  subsequently  con- 
taminate the  system  ?  Let  us  postpone  the  consideration  of  an 
answer  until  we  come  to  include  glanders  in  the  same  family  of 
poisonous  influences."  Professor  Coleman  adduces  as  proofs  that 
it  is  not  a  local  affection : — "  1st.  The  constitutional  derange- 
ment, which  he  says  may  often  be  traced  to  the  digestive  organs 
and  skin,  and  is  in  some  respects  unlike  simple  irritative  disor- 
der; 2d.  The  character  of  the  inflammation,  which  is  neither 
so  acute  nor  so  rapidly  progressive  as  simple  ophthalmia  often 
is,  and  yet  the  one  readily  yields  to  proper  treatment,  whilst  the 
other  obstinately  continues  its  course ;  od.  The  eye  may  be 
locally  exposed  to  volatile  ammonia,  or  any  animal  effluvium  we 
can  obtain  by  artificial  means,  and  no  such  effect  will  be  pro- 
duced."— (Percivall's  Lectures  on  the  Veterinary  Art) 

I  have  nothing  to  suggest  with  regard  to  successful  treatment. 
The  disease  is  incurable,  and  has  baffled  the  eftbrts  of  all  who 


PERIODIC  OPHTHALMIA.  559 

have  endeavoured  to  combat  it.  It  is  very  true  that  the  in- 
flammatory stage  is  seemingly  modified  and  cut  short  by  various 
remedies ;  but  the  disease  recurs,  and  terminates  only  when  the 
sight  is  completely  destroyed.  Some  writers  affirm  that  when  it 
attacks  both  eyes  alternately  it  is  better  to  destroy  the  one  and 
save  the  other — that  when  one  is  destroyed  it  occurs  no  more. 
Surely  this  is  a  mistake.  I  have  over  and  over  again  seen  it 
attack  one  eye  repeatedly  until  cataract  was  completely  de- 
veloped, then  attack  the  other  until  the  same  result  was  produced. 

An  acute  attack  is  always  accompanied  by  febrile  disturb- 
ance; to  relieve  this  a  purgative  is  useful,  to  be  succeeded  by 
febrifuges,  such  as  the  nitrate  of  potash,  aconite ;  and,  meting 
upon  the  knowledge  that  effete  materials  are  circulating  in  the 
system,  colchicum  may  be  given  with  advantage.  The  local  pain 
is  to  be  soothed  by  fomentations,  anodyne  collyria  and  belladonna, 
but  no  irritatincp  materials  should  be  made  use  of. 

Prevention  is  of  greater  importance  than  attempts  to  cure 
what  has  already  proved  itself  beyond  the  reach  of  any  and  every 
known  remedy. 

Horses  subject  to  this  disease  continually  change  owners ; 
and,  as  a  legal  question,  the  ability  to  discriminate  between  the 
healthy  and  unsound  eye  becomes  a  matter  of  great  importance 
to  the  veterinarian ;  and  Mr.  Percivall  says,  very  correctly — 
"  Any  single  one  of  the  following  appearances  may,  unless  its 
origin  can  be  satisfactorily  traced  to  simple  ophthahnia,  excite 
our  suspicions ;  but  a  combination  will  warrant  an  unfavourable 
prognostic : — ^A  sunken  or  gloomy  aspect  of  the  eye  altogether, 
compared  with  the  other ;  prominence  of  the  membrana  nictitans ; 
vascularity  or  pinkness  of  the  conjunctiva;  a  watery  state  of 
the  eye;  dimness  or  cloudiness  of  the  cornea,  particularly 
around  its  margin ;  dulness  or  discoloration  of  the  iris ;  corpora 
nigra  yellowish,  whitish,  or  spotty ;  pupil  smaller  than  the  other ; 
perhaps  hazy  or  milky,  or  containing  a  minute  white  speck  in 
its  centre,  which  is  an  incipient  cataract." 

Another  symptom,  and  one  of  great  importance,  wliich  Mr. 
Percivall  does  not  notice,  is  the  wrinkled  or  furrowed  appearance 
of  the  upper  lid  and  eyebrow. 

The  common  termination  of  periodic  ophthalmia,  viz., 
cataract,  is  a  very  important  subject  to  consider  in  its  medico- 
legal aspect. 


oCO  DISEASES  OF  THE  EYES. 

A  cataract  is  usually  developed  as  follows : — "  A  grey  or 
white  speck  is  seen,  after  the  subsidence  of  the  acute  inflamma- 
tory stage  of  periodic  ophthalmia,  in  the  centre  of  the  pupil ;  this 
grows  at  each  successive  attack  until  it  quite  fills  up  the  aper- 
ture ;  vision  grows  less  and  less  distinct  during  its  formation. 
The  growth  of  the  incipient  speck  during  the  time  that  the  organ 
is  suffering  from  ophthalmia  is  commoidy  rapid ;  but  as  soon  as  the 
inflammatory  action  has  subsided,  its  progress  becomes  compara- 
tively slow,  and  now  and  then  it  appears  to  remain  quite  sta- 
tionary ;  for  as  soon  as  cataract  has  formed,  the  inflammation 
generally  begins  to  dechne,  and  the  eye  seldom  receives  another 
attack ;  there  are,  however,  some  exceptions  to  this.  And  it  is 
also,  I  beheve,  an  established  fact,  that  not  only  does  the  in- 
flammation permanently  leave  the  cataractous  eye,  but,  should 
the  other  have  remained  free  from  the  disease,  it  is  in  less 
danger  of  beins^  attacked.  Under  such  circumstances,  there- 
fore,  a  cataract  is  hailed  as  a  favourable  omen ;  this  is  expU- 
cable,  seemingly,  on  the  principle  of  sympathy,  which  is  known 
to  have  great  influence  in  ophthalmic  pathology,  and  the  cir- 
cumstance has  been  considered  weighty  enough  to  recommend 
the  artificial  destruction  of  one  eye  in  disease  to  preserve  the 
other  in  health." — (Percivall.) 

Although  cataract  is  generally  a  sequel  to  periodic  ophthalmia, 
it  by  no  means  follows  that  this  is  the  only  cause.  Many  in- 
stances of  fully  developed  cataracts  in  both  eyes  have  come 
under  my  immediate  observation  without  any  preceding  inflam- 
mation. At  the  present  time  I  have  a  carriage-horse  under 
my  care.  Four  years  ago  I  examined  liim  as  to  his  soundness, 
and  passed  him.  I  have  seen  him  continually  during  tliis 
period,  and  am  positive  he  has  not  suflered  from  any  acute 
disease  of  the  eyes.  Some  two  months  ago  he  began  to  exhibit 
symptoms  of  defective  vision,  by  shying,  &c.  Upon  examination, 
I  found  a  star-like  cataract  in  each  eye;  these  have  rapidly 
increased  in  size,  and  they  now  embrace  nearly  the  whole 
structure  of  the  lens,  but  there  is  not  a  trace  of  inflammation 
in  either  eye,  nor  has  there  been  any  since  I  first  examined  him. 

Writers  upon  human  ophthalmic  surgery  ascribe  cataract  to 
a  great  variety  of  causes. 

1st.  In  some  cases  a  blow  in  the  eye,  without  any  penetration 
of  its  tunics,  ruptures  the  capsule;   while  in  others,  cataract, 


PERIODIC    OPHTHAOnA.  561 

generally  attended  by  amaurosis,  follows  a  blow  on  the  eye, 
or  a  blow  or  fall  on  the  edge  of  the  orbit,  without  any  apparent 
rupture  or  dislocation.  This  effect  may  not  show  itself  for  seve- 
ral years  after  the  injury." — (Mackenzie's  Practical  Treatise  on 
Eye,  1854) 

"  The  lens  may  become  opaque  in  consequence  of  a  blow  or 
concussion  of  the  eye  without  solution  of  continuity.  I  have 
seen  many  such  instances. 

"  In  a  patient  who  had  received  a  blow  in  the  eye  from  the 
fist,  seen  by  Beer  in  twenty-four  hours  after  the  accident,  the 
capsule  was  torn,  the  lens  split  in  two  and  quite  opaque,  there 
was  slight  effusion  of  blood  into  the  anterior  chamber,  and  con- 
siderable ecchymosis  of  the  conjunctiva." — (Laueence  on  the 
Eye,  1844) 

2d.  "  Lenticular  cataract  consists  in  a  marasmus  and  opacity 
of  the  proper  substance  of  the  lens,  and  not  in  any  opaque 
deposit ;  but  nothing  is  known  of  the  exact  nature  of  the  change. 
It  may  be  looked  uj^on  in  some  degree  as  a  natural  effect  of  old 
age." — (Wharton  Jones.) 

The  late  Sir  David  Brewster  was  of  opinion  that  at  least  one 
cause  of  cataract  was  an  inordinate  saline  condition  of  the 
aqueous  humour,  and  that,  owing  to  this  extreme  salinity  of  the 
humour  (upon  the  principle  of  exosmosis  and  endosmosis),  the 
fluid  contained  in  the  lens  became  diminished,  its  concentric 
laminse  being  thus  separated  from  each  other,  and  that  the 
proper  treatment  for  cataract  was  abstraction  of  the  aqueous 
humour  by  puncturing  the  cornea,  after  which  the  patient  was 
to  abstain  from  partaking  of  salt  with  food. 

All  cataracts  have  been  classified  under  two  heads,  namely, 
the  true  and  the  s;purious. 


TRUE  cataracts. 

The  opacity  may  be  seated  in  the  lens  itself,  or  in  its  capsule, 
or  in  both  lens  and  capsule  at  the  same  time  ;  different  kinds  of 
true  cataracts  are  accordingly  described,  namely,  lenticular, 
capsular,  and  capsulo-lenticular.  The  distinction  of  these 
different  kinds  is  not  of  such  great  importance  to  the  veterina- 
rian as  to  the  human  oculist,  as  operation  for  the  removal  of 

2o 


562  DISEASES   OF  THE  EYES. 

cataract  is  inadmissible  in  the  lower  animals ;  total  blindness 
being  preferable  to  imperfect  vision. 

Again,  cataracts  are  described  by  the  terms  hard  and  soft. 
Hard  cataract  is  that  commonly  seen  in  the  horse ;  in  the  dog 
soft  cataract  is  generally  met  with ;  it  is  a  very  common  disease 
in  this  animal,  and  is  not  preceded  by  any  signs  of  inflammation. 
It  presents  in  its  earlier  stages  a  glistening  tendinous  aspect, 
and  a  stellate  appearance,  resembling  a  healthy  lens  made 
opaque  by  the  action  of  re-agents.  The  lens  seems  larger  than 
natural,  and  the  pupil  is  generally  dilated. 

Pet  dogs  that  are  over-fed,  especially  those  which  are  fond 
of  sugar,  frequently  become  blind  from  cataract.  I  have  known 
some  cases  apparently  recover  under  a  more  healthy  regimen, 
and  when  compelled  to  take  exercise,  but  ordinarily  the  lens 
assumes  the  appearance  of  broken  spermaceti. 

Spurious  or  false  cataracts,  so  called  in  contra-distinction 
to  opacities  of  the  lens,  consist  in  opaque  deposits  of  lymph, 
blood,  or  pus  on  the  anterior  capsule,  obstructing  the  pupil. 
They  may  originate  in  severe  traumatic  ophthalmia,  or  they 
may  co-exist  with  true  cataract,  and  arise  from  the  same  cause. 
As  a  m.edico-legal  question,  the  time  necessary  for  the  formation 
of  cataract  becomes  a  subject  of  great  importance.  The  case  of  • 
Lord  Eandolph  Churchill  versus  Day  has  an  important  bearing 
upon  it,  as  well  as  upon  the  liability  of  veterinary  surgeons. — 
See  Veterinarian,  1871. 

Usually  cataract  is  only  completely  developed  after  repeated 
attacks  of  periodic  ophthalmia,  and  in  a  period  of  time  varying 
from  two  to  twelve  months ;  but  there  are  cases  where  one 
attack  is  sufficiently  severe  to  destroy  not  only  the  transparency 
of  the  lens,  but  the  integrity  of  the  whole  organ  of  vision ;  and, 
to  state  what  has  happened  in  my  own  experience,  a  fully 
formed  cataract  has  been  developed  in  ten  days  from  the 
commencement  of  an  attack  of  ophthalmia ;  the  opacity  of  the 
anterior  portion  of  the  eye  being  removed  to  such  an  extent 
as  to  allow  the  cataract  to  be  plainly  visible.  Such  an  instance 
as  this  is  rare. 

I  have  already  stated  that  cataract  in  the  horse  may  proceed 
from  other  causes  than  inflammation,  and  it  will  be  well  to 
bear  this  in  mind,  should  an  action  at  law,  similar  to  the  one 
already  quoted,  be  raised  at  some  future  time. 


DISLOCATION  OF  THE  EYEBALL.  563 

DISLOCATION  OF  THE  EYEBALL. 

This  is  not  at  all  an  uncommon  occurrence  in  dogs,  par- 
ticularly in  those  beautiful-eyed  ones,  the  King  Charles  spaniel. 
The  cause  is  accidental,  a  fight  with  another  dog,  or  more 
commonly  with  a  cat.  The  eye  is  actually  "  scratched  out," 
and  hangs  pendulous  on  the  cheek.  In  all  such  cases  the  eye 
must  be  returned,  and,  wonderful  to  relate,  the  after  usefulness 
of  the  organ  is  not  always  impaired. 

The  method  of  returning  the  eye  is  as  follows  : — After  wash- 
ing away  all  extraneous  matters,  dirt,  blood,  &c.,  with  tepid 
water,  let  an  assistant,  who  is  to  stand  behind  the  dog,  open 
the  eyelids  as  far  apart  as  possible,  then  the  operator  is  to  press 
gently,  but  firmly,  upon  each  side  of  the  anterior  aspect  of  the 
dislocated  globe  with  the  balls  of  his  thumbs  until  the  globe  is 
replaced  within  the  orbit.  But  should  such  pressure  prove 
ineffectual,  the  outer  angle  of  the  eyelid  is  to  be  divided  with 
a  pair  of  scissors  or  bistoury — a  small  snip  is  sufficient — when 
the  eye  can  be  replaced  without  difficulty ;  the  incision  in  the 
lids  being  afterwards  drawn  together  by  a  single  suture.  It 
must  be  borne  in  mind  that  in  reducing  dislocation  of  the  eye, 
extreme  pressure  must  be  avoided,  or  the  eye  will  be  irretriev- 
ably damaged,  and  that  pressure  is  to  be  exerted  more  upon  the 
sides  than  upon  the  front  of  the  globe,  for  pressure  on  the  front 
will  flatten  it,  and  cause  it  to  bulge  laterally. 

REMOVAL   OF  THE  EYEBALL. 

Except  in  malignant  disease,  it  is  not  necessary  to  remove 
the  whole  of  the  eye ;  if  the  cornea  is  removed,  the  humours, 
lens,  &c.,  escape,  the  eye  will  collapse,  and  its  various  coats 
become  adherent.  Eemoval  of  the  eye  is  sometimes  necessary 
in  dogs  suffering  from  irritating  staphyloma  or  incurable 
ulcers  on  the  cornea,  and  in  the  horse  after  severe  injuries  to 
the  eye,  resulting  in  permanent  tumefaction  and  enlargement 
of  the  whole  organ,  preventing  closure  of  the  eyelids,  and 
subjecting  the  animal  to  much  pain  from  the  irritation  of  dust 
or  other  foreign  bodies. 

EXAMINATION   OF   THE   EYE. 

An  ordinary  examination  of  the  eye  is  made  by  turning  the 


564  DISEASES   OF  THE   EYES. 

horse's  head  away  from  a  strong  light,  shading  the  eye  with 
a  Hack  hat,  and  obscuring  any  white  article  of  clothing  that 
the  examiner  may  be  wearing  at  the  time.  But  in  doubtful 
cases  of  soundness  of  the  eyes,  a  more  searching  test  is  required, 
and  the  mode  of  examination  is  by  reflection  of  light,  called 
the  catoptric  test.  For  the  application  of  this  test,  the  horse 
must  be  put  in  a  dark  place,  and  should  the  pupil  be  sensitive 
to  light,  it  must  be  dilated  with  belladonna. 

When  a  lighted  candle  is  moved  before  the  healthy  eye,  three 
images  of  it  may  be  observed.  First,  the  erect  image,  that 
moves  in  the  same  direction  as  the  candle,  is  produced  by 
reflection  from  the  surface  of  the  cornea ;  secondly,  another  erect 
image,  produced  from  the  anterior  surface  of  the  crystalline 
lens,  which  also  moves  in  the  same  direction;  and  thirdly,  a 
small  inverted  image,  situated  between  the  other  two,  is  reflected 
from  the  posterior  surface  of  the  lens,  and  moves  in  the  contrary 
direction  to  the  others  and  to  the  movements  of  the  candle 

In   cataract   the   inverted   imag^e   is    rendered    indistinct  or 

CD 

abolished,  and  the  second  erect  one  sometimes  abolished  also. 
In  glaucoma,  the  deep  (or  second)  erect  image  is  rendered  more 
evident  than  in  a  sound  eye,  and  it  is  only  in  a  very  advanced 
stasre  that  the  inverted  ima2:e  is  obliterated.  In  amaurosis  all 
the  images  are  as  distinct  as  in  the  healthy  eye. 

EXAMINATION  BY  THE   OPHTHALMOSCOPE. 

Very  small  cataracts  are  discoverable  only  with  the  aid  of 
this  instrument ;  the  catoptric  test  not  being  always  sufficiently 
satisfactory. 

In  order  to  examine  with  the  ophthalmoscope,  much  practice 
with  the  instrument  is  required,  and  the  veterinarian  should 
become  an  adept  in  its  use  before  resorting  to  it  in  an  important 
case. 

A  dark  place  is  necessary,  and  the  examination  is  much 
facilitated  by  first  dilating  the  pupil  with  belladonna. 

The  examiner  is  to  stand  in  front  of  the  horse,  with  the 
instrument  in  his  hand.  An  assistant  stands  near  the  horse's 
shoulder,  holding  a  lighted  candle  (this  is  better  than  a  stronger 
light).  The  examiner  is  to  manipulate  his  instrument  until  the 
light  of  the  candle  is  reflected  into  the  horse's  eye ;  in  many 


EXAMINATION  BY  OPHTHALMOSCOPE.  565 

cases  tliis  is  sufficient  to  bring  an  opacity  of  the  lens  distinctly 
into  view,  a  cataract  looking  like  a  dark  or  black  spot  in  the 
illuminated  eye ;  but  should  this  not  prove  sufficient,  the  eye 
may  be  magnified  by  the  lens  which  accompanies  the  ophthal- 
moscope, and  the  examiner  can  limit  his  vision  to  the  eye  by 
looking  through  the  small  aperture  at  the  back  of  the  instru- 
ment. 

It  may  here  be  mentioned  that  the  small  instruments  made 
use  of  by  oculists  are  the  best ;  the  larger  ones  made  by 
veterinary  instrument  makers  are  not  nearly  so  good,  and  are 
apt  to  deceive. 


CHAPTER  XXXII. 

DISEASES  OF  THE  HEAD,  NECK,  VEINS,  ETC. 

OTORRH(EA — EXTERNAL  CANKER  OF  THE  EAR — POLL-EVIL FISTULOUS 

WITHERS CIRCUMSCRIBED   AND    DIFFUSE    PHLEBITIS THROMBUS 

VARICOSE  VEINS — PHLEBOLITES — ENTRANCE  OF  AIR   INTO   THE 

VEINS. 

DISEASES  OF  THE  EAR. 

With  tlie  exception  of  liability  to  accidental  injuries — and 
gangrene  of  the  concha  sometimes  seen  in  scarlatina — the  ear  of 
the  horse  seems  exempt  from  disease;  the  dog,  however,  is 
subject  to  two  well-known  forms  of  disease  of  the  ear,  namely, 
internal  and  external  canker. 

Internal  Canker,  Otorrhcea,  is  an  inflammation  of  the  lining 
membrane  of  the  meatus  auditorius  exfernus,  with  a  discharge 
of  purulent  matter,  sometimes  mixed  with  blood,  which  may 
occasionally  coagulate,  block  up  the  tube,  and  cause  deafness. 
When  the  inflammation  extends  to  the  internal  ear  it  constitutes 
"  otitis,"  a  most  painful  affection,  causing  constitutional  disturb- 
ance, in  some  instances  delirium,  coma,  and  death.  The  inflam- 
mation of  the  mucous  lining  of  the  outer  meatus  is  very  often 
aggravated,  and  otitis  produced  by  irrational  treatment. 

The  disease  occurs  chiefly  in  spaniels  and  retrievers,  but  no 
breed  is  exempt ;  the  practice  of  "  cropping  the  ears  "  does  not 
seem  to  predispose  to  it ;  indeed,  it  is  mostly  met  wdth  in  dogs 
with  pendulous  ears.  The  origin  of  the  disease  is  local  or 
constitutional ;  the  local,  caused  by  the  lodgment  of  water,  dirt, 
or  any  foreign  matter  in  the  meatus ;  and  the  constitutional, 
arising  from  improper  and  over-feeding,  want  of  exercise,  catar- 
rhal affections,  and  the  extension  of  skin  diseases. 

Treatment. — Wlien  of  local  origin,  the  treatment  must  be 
directed  to  the  subjugation  of  the  inflammation  by  local  soothing 


DISEASES  OF  THE  EAR.  567 

applications,  such  as  warm  fomentations  to  the  pait,  weak  sohi- 
tions  of  acetate  of  lead  and  opium  applied  warm  (poured,  not 
injected)  to  the  ears.  A  purgative  should  be  administered  in  the 
first  stages,  and  the  animal  kept  on  a  cooling  diet  for  a  few  days. 

This  method  of  treatment  will  generally  afford  relief;  but 
should  the  disease  continue,  a  stronger  astringent  is  to  be 
applied,  or  it  may  be  necessary  to  stimulate  the  part  to  healthy 
action  by  the  nitrate  of  silver,  of  the  strength  of  five  grains  to 
the  ounce  of  water.  As  an  astringent,  a  solution  of  the  ter- 
chloride  of  iron  is  a  very  effectual  one,  and  it  may  be  necessary 
to  inject  it  with  a  syringe :  however,  great  caution  must  be 
exercised,  and  violent  remedies  avoided,  if  possible,  in  the 
treatment  of  what  is  already  a  painful  affection.  If  this  caution 
is  not  exercised,  much  suffering  is  inflicted  upon  a  dumb  beast, 
and  a  tractable  disease  rendered  incurable.  If  the  dog  be  in  a 
debilitated  condition,  either  from  the  long  continuance  of  the 
disease,  or  want  of  proper  diet  and  attention,  he  must  be  sup- 
ported with  good  food,  and  stimulated  with  tonics,  the  sulphate 
of  quinine  more  particularly. 

In  those  painful  forms  where  acute  otitis  exists  with  febrile 
disturbance,  great  restlessness;  and  the  animal  often  howling 
with  pain,  rubbing  his  ears  and  head  with  his  paws,  and 
evidencing  signs  of  much  irritability,  the  general  and  local 
treatment  must  be  of  an  active  kind ;  continual  fomentations  with 
warm  water,  or  a  decoction  of  poppies  must  be  prescribed ;  a 
seton  inserted  behind  the  ear,  and,  in  addition  to  a  brisk 
cathartic,  small  and  repeated  doses  of  the  tincture  of  aconite,  or 
a  solution  of  morphia,  are  to  be  administered. 

When  the  cause  is  constitutional,  the  general  health  of  the 
dog  must  be  attended  to,  and  in  «ome  cases  I  have  found  it 
necessary  to  prescribe  a  continuance  of  tonic  alteratives,  such  as 
the  liquor  arsenicalis,  with  an  occasional  aperient. 

EXTERNAL  CANKER. 

This  is  an  abraded  or  wounded  condition  of  the  tip  of  the 
ear,  arising  from  accidental  injury,  or  from  the  clog,  especially  a 
water  dog,  violently  shaking  his  head  and  ears.  Earely  is  this 
affection  found  in  any  but  long-eared  dogs,  and  in  them,  owing  to 
the  habit  of  shaldng  the  head,  it  is  almost  an  incurable  disease. 


568  DISEASES  OF  THE  HEAD,  NECK,  VEINS,  ETC. 

The  abrasion  or  wound  may  at  first  be  exceedingly  small,  a 
mere  bruise  on  the  border  of  the  ear  ;  but  after  a  time  the  tip  of 
the  ear  commences  to  split,  the  cleavage  being  increased  by  the 
repeated  shakings  of  the  head  and  violent  flapping  of  the  ears. 
The  treatment  must  first  be  directed  to  the  prevention  of  this 
shaking,  and  for  this  purpose  a  net-cap  must  be  fastened  around 
the  dog's  head  and  ears.  A  French  authority  recommends  the 
application  of  a  blister  over  the  external  surface  of  the  ear. 
This  allays  the  intolerable  itching,  and  substitutes  a  smart  pain, 
which  prevents  the  shaking  of  the  ear.  This  precaution  against 
further  injury,  with  cleanliness,  a  purgative,  regular  food  and 
exercise,  a  gentle  touch  of  the  nitrate  of  silver,  and,  as  in  in- 
ternal canker,  preventing  the  dog  from  "  taking  the  water,"  will 
generally  effect  a  cure.  If  the  ear  be  split  to  any  depth,  and  if, 
after  a  recovery  and  removal  of  the  cap,  the  wound  again  begins 
to  spread,  the  edges  of  the  cleft  must  be  pared  and  brought 
together  by  fine — ^metallic — sutures,  and  at  the  same  time  all 
diseased  portions  upon  the  tip  removed  with  the  knife.  If  the 
edges  do  not  completely  unite  after  one  operation,  it  must  be 
repeated  until  they  do  so  ;  and  failing  to  cure  by  these  means, 
the  dog  must  be  *•'  cropped." 


POLL-EVIL. 

This  is  a  fistulous  ulcer  situated  on  the  supero-posterior  por- 
tion of  the  cranium  immediately  behind  the  ears  of  the  horse, 
and  is  caused  by  accidental  violence,  or  by  the  habitual  use  of 
a  tight  bearing-rein. 

At  the  first  stage  it  may  be  recognised  as  a  soft  fluctuating 
tumour  surrounded  by  inflammatory  swelling,  enlargement  of 
the  superior  cervical  lymphatics,  and  stiffness  of  the  neck ;  or 
the  inflammation  of  the  surrounding  tissue  may  have  subsided, 
leaving  a  prominent  swelling — a  serous  abscess. 

Treatment  2'^'i^o]oer  hefore  pus  is  formed. — Eeduce  the  inflam- 
mation, if  present,  by  the  application  of  cold  water  to  the 
part,  and  by  the  administration  of  purgatives  internally.  When 
the  inflammation  is  overcome,  reduce  the  swelling  by  friction 
with  iodine,  hut  do  not  puncture;  but  if  suppuration  is  esta- 
blished, the  abscess  cannot  be  opened  too  soon,  and  it  is  best  to 
make  the  incision  at  its  base,  to  allow  the  pus  to  escape  from 


POLL-EVIL.  569 

its  most  inferior  part.  For  this  purpose,  a  free  incision  is  to  be 
made,  and  it  must  not  be  allowed  to  close  too  soon ;  fomenta- 
tions are  to  be  repeatedly  applied,  but  no  special  application 
is  required,  the  ordinary  treatment  for  abscess  being  all  that  is 
necessary. 

If  the  abscess  has  already  burst,  is  discharging  a  foetid  un- 
healthy pus,  and  the  opening  is  surrounded  with  fungous  gi^anula- 
tions,  the  disease  will  be  found  to  have  assumed  a  most  for- 
midable aspect ;  for  not  only  will  the  subcutaneous  areolar  and 
muscular  tissues  be  involved,  but  the  ligaraentum  mccJice  also ; 
which,  being  tough  and  elastic,  imprisons  the  pus,  causing  it  to 
burrow  in  various  directions,  and,  having  a  low  organization,  its 
healing  powers  are  exceedingly  torpid.  The  treatment  of  a  case 
of  this  description  is  a  matter  of  some  difficulty,  and  to  be  com- 
plete, a  thorough  examination  must  be  made  with  the  probe  of 
all  the  fistulous  ulcers  and  sinuses.  These  must  be  freely  laid 
open  to  their  very  base,  and  the  whole  dressed  with  a  solution  of 
the  bichloride  of  mercury,  the  chloride  of  zinc,  or  the  muriate  of 
antimony;  a  thin  layer  of  the  parts  laid  open  w-ill  thus  be 
destroyed,  and  the  wdiole  converted  into  a  common  wound.  The 
repeated  applications  of  caustics  and  escharotics  are  not  required, 
indeed  they  do  much  harm ;  when  once  the  part  is  converted 
into  a  healthy-looking  wound,  all  that  is  necessary  is  to  keep  it 
clean,  dress  with  mild  astringents,  and  prevent  the  opening  from 
closing  too  quickly. 

In  many  cases,  setons  inserted  from  the  original  opening  along 
the  direction  of  the  fistulae,  and  brought  out  upon  the  opposite 
side  of  the  poll,  are  very  successful;  but  if  there  be  many  sinuses, 
the  seton  treatment  is  not  to  be  depended  upon,  and  it  is  better 
to  use  the  knife  freely. 

When  poll-evil  is  caused  by  the  bearing-rein,  it  is  deep- 
seated,  perhaps  involving  the  synovial  membrane  of  the  occipito- 
atloidean  articulation,  and  some  cases  have  terminated  in 
anchylosis  of  tliis  joint,  causing  the  animal  to  be  permanently 
stiff-necked.  In  some  instances  the  ulcerative  process  has 
penetrated  the  capsules  of  the  first  or  second  cervical  articula- 
tions, causing  sudden  death  by  pressure  upon  the  medulla 
spinalis  ;  in  others,  pieces  of  the  bones  become  detached,  keep- 
ing up  the  irritation  and  formation  of  pus ;  these  must  be 
searched  for  and  carefully  removed. 


570  DISEASES  OF  THE  HEAD,  NECK,  VEINS,  ETC. 


FISTULOUS  WITHERS. 

ristiilous  withers  resembles  poll-evil  in  all  particulars  except 
its  seat.  It  is  caused  bv  bruises  from  ill-fittiner  saddles ;  but 
some  horses,  from  the  conformation  of  the  withers,  are  more 
prone  to  be  thus  injured  than  others.  Horses  with  high  withers 
are  particularly  liable  to  the  injury.  Sometimes  the  spines  of 
the  dorsal  vertebrae  become  affected  with  chronic  inflammation 
from  repeated  bruisings ;  their  extremities  spread  out,  or  some 
l^ortions  of  them  become  necrosed.  These  are  complicationfj 
which  must  be  provided  for  in  the  treatment,  which  is  to  be 
conducted  upon  the  same  principles  as  that  for  poll-evil,  namely, 
to  make  a  depending  orifice  for  the  discharge  of  purulent  matter, 
either  by  seton,  incision,  or  by  a  counter-opening  made  at  a  point 
below  the  bottom  of  the  sinus. 


INFLAMMATION  OF  THE  JUGULAR  VEIN. 

Inflammation  of  the  jugular  vein  occurs  as  a  sequel  to  bleeding 
(phlebotomy),  and  is  due  to  a  constitutional  predisposition  to 
local  inflammation — as  in  that  condition  co-existent  with  acute 
laminitis — accidental  disturbance  of  the  wound  after  the  opera- 
tion, or  to  carelessness  on  the  part  of  the  operator. 

In  order  to  secure  the  healing  of  the  puncture  made  by  the 
lancet  or  fleam,  by  immediate  union,  it  is  necessary  to  bring  the 
lips  of  the  wound  immediately  and  closely  together.  The  blood, 
if  any,  on  its  surface  is  thus  pressed  out,  and  the  divided  blood- 
vessels and  nerves  are  brought  into  perfect  contact.  Union 
may  thus  be  effected  in  a  few  hours.  If  this  method  of  union 
is  not  secured,  the  wound  may  heal  by  the  adhesive  inflamma- 
tion; but  if  sujDpuration  occur,  the  inflammation  will  in  all 
probability  extend  to  the  coats  of  the  vein. 

The  more  immediate  causes  of  phlebitis  are  said  to  be,  using 
a  rusty  fleam,  bungling  in  performing  the  operation,  or  from  the 
animal  rubbing  the  pin  against  the  stall  or  manger. 

Fatliology. — Inflammation  of  a  vein  is  characterised  by  a 
leddeninf?  of  all  its  coats,  owincj  to  conixestion  of  its  vasa 
vasorum;  an  exudation  is  poured  out  from  the  coats  of  the 
vein,  which,  along  with  its  contents,  forms  a  solid  coagulum. 
Tlie  experiments  of  Gendrin  go  to  prove  that  the  clot  is  not 


INFLAMMATION  OF  THE  JUGULAR  VEIN.  571 

wholly  due  to  coagulation  of  the  blood  contained  in  the  inflamed 
portion  of  the  vein ;  for  he  found,  when  a  portion  of  a  vein  was 
insulated  by  securing  it  between  two  ligatures,  emptied  of  its 
blood,  and  inflammation  excited  by  an  irritant  injection,  that  a 
plastic  solid  substance  was  formed,  which  filled  up  the  whole 
calibre  of  the  vessel.  In  some  instances  the  plug  is  formed  of 
concentric  layers  of  straw-coloured  lymph,  with  a  dark  san- 
guineous clot  in  its  centre.  At  first  the  clot  is  but  loosely 
attached  to  the  interior  of  the  vessel,  but  subsequently  it  be- 
comes more  strongly  adherent,  the  surrounding  areolar  tissue 
infiltrated  with  serum,  and  that  in  contact  with  the  vein  ad- 
herent to  it  by  a  fibrinous  exudate.  In  this  manner  the  vein 
and  surrounding  textures  are  firmly  united. 

Traumatic  inflammation  of  the  jugular  vein  is  always  circum- 
scribed— sometimes  "  suppurative"  sometimes  ''fibrinous"  The 
thrombus  or  coagulum  extends  in  an  upward  direction  (from  the 
wound)  considerably  beyond  the  primary  seat  of  the  inflamma- 
tion, and  terminates  in  a  conical  point.  The  inflammation  may 
terminate  by  this  clot  becoming  organized,  and  the  vein  con- 
verted into  an  impervious  cord,  without  the  advent  of  the  sup- 
purative process ;  but  in  the  majority  of  cases  one  or  two  cir- 
cumscribed swellings  appear  along  the  course  of  the  coagulum, 
in  which  fluctuation  and  the  other  characters  of  abscesses  may 
be  detected.  The  pus  in  these  abscesses  is  confined  by  a 
coao-ulum,  above  and  below,  which  forms  a  barrier  to  its  admis- 
sion  into  the  general  circulation. 

Whilst  these  changes  are  going  on  in  the  inflamed  vein,  the 
lips  of  the  wound  are  separated,  everted,  are  redder  than  natural, 
and  discharge  a  sanious  material,  mingled  with  blood ;  the  sur- 
rounding parts  also  are  in  a  state  of  tumefaction  and  tension, 
whilst  the  vein  in  its  course  towards  the  head  conveys  the 
sensation  to  the  fingers  of  a  hard  cord  of  considerable  thickness. 

It  seems  peculiar  that  the  formation  of  the  thrombus  or  clot 
should  extend  towards  the  head  and  from  the  heart  in  inflam- 
mation of  the  jugulars,  and  towards  the  heart  when  other  veins, 
such  as  the  brachials  or  saphence,  are  accidentally  inflamed.  We 
are  not  to  suppose  that  the  inflammation  does  not  extend  below 
as  well  as  above  the  puncture  in  phlebitis  of  the  jugular;  in- 
deed, a  thickening  of  the  coats  of  the  vessel  can  be  distinctly 
felt  through  the  skin,  but  the  obliterating  clot  is  not  found 


572  DISEASES  OF  THE  HEAD,  NECK,  VEINS,  ETC. 

"below  the  seat  of  puncture ;  and  Mr.  Percivall,  in  treating  on  this 
subject,  has  been  at  much  pains  to  account  for  this  peculiar  dis- 
position in  the  inflammation  to  extend  so  generally  towards  the 
head  when  the  jugular  is  punctured,  and  towards  the  heart  when 
it  takes  place  in  any  other  vein;  being  in  the  one  instance 
against  the  course  of  the  circulation,  and  in  the  other  with  it,  as 
is  invariably  seen  in  the  human  being.  To  reconcile  these  seem- 
ing discrepancies,  Mr.  Percivall  observes,  "  that  although  the  db- 
strudccl  state  of  the  vessel  is  not  the  exciting  cause  of  the  in- 
flammation, it  invariably  directs  the  course  of  it.  It  therefore 
remained  to  inquire  in  what  manner  the  obstruction  was  pre- 
vented in  the  previous  course  of  other  veins  similarly  affected, 
as  the  saphena  and  plate  vein  of  the  horse,  and  the  basilic  and 
cephalic  of  the  human."  Now  these  veins,  Mr.  Percivall  ingeniously 
argues,  freely  anastomosing  with  contiguous  trunks,  preserve  a 
continual  flow  of  blood  up  to  the  obliterated  part;  but  above 
this,  such  anastomosis  does  not  exist,  the  communicating  branches 
being  few  and  small ;  consequently,  the  blood  remains  to  coagu- 
late and  to  continue  the  disease.  The  jugular  is  similarly  situated 
upwards,  for  it  has  no  anastomosis  to  carry  off  the  obstructed 
blood  above  the  puncture,  in  which  direction,  therefore,  the  in- 
flammation proceeds,  the  obstruction  being  prevented  downwards 
towards  the  heart ;  for,  having  once  emptied  itself,  the  inflam- 
mation and  tumefaction  will  prevent  its  receiving  more  blood,  by 
which  means  no  offending  coagulum  remains.  Thus  Mr.  Percivall 
argues  that  the  deviation  from  what  is  considered  as  a  fixed  law 
in  human  pathology — that  tJiis  inflammation  always  occasions 
obliteration  in  the  vein  toivarcls  the  heart — is  thus  reconciled,  and 
that  "  the  same  cause  is  operating  under  different  circumstances." 
— Lectures,  vol.  i.,  p.  103. 

Speaking  to  Professor  Spence  of  this  peculiar  tendency  in  the 
clot  to  extend  upwards  in  inflammation  of  the  jugulars,  he  kindly 
showed  me  a  specimen  of  inflammation  of  these  veins  in  man, 
where  the  thrombi  extended  upwards  even  to  the  cranial  sinuses. 
From  this  circumstance  I  think  we  may  safely  conclude  that  the 
same  law  applies  in  man  as  in  the  horse. 

The  best  treatment  for  circumscribed  phlebitis  is  the  appli- 
cation of  a  smart  cantharides  blister  along  the  course  of  the  in- 
flamed part,  and  a  cure  will  be  effected  in  a  very  short  time. 
The  blister  is  to  be  applied  whether  suppuration  be  present  or 


INFLAMMATION  OF  THE  JUGULAR  VEIN.  573 

otherwise.  If  abscesses  have  abeady  formed,  they  must  be 
opened  before  the  blister  is  applied,  for  if  this  precaution  be 
not  taken,  the  pus  may  break  down  the  barrier  which  surrounds 
it,  thus  entering  the  circulation,  and  leading  to  very  serious  or 
even  fatal  consequences. 

I  find  that  writers  upon  human  surgery  recommend  leeches, 
fomentations,  poultices,  and  other  metliods  of  treatment  which 
— in  veterinary  practice,  at  least — have  been  found  to  retard 
the  healing  process,  and  I  would  suggest  very  respectfully  that 
the  method  by  blistering  is  worthy  of  their  consideration. 

Inflammation  of  the  jugular  always  terminates  in  the  conver- 
sion of  the  vessel  into  an  impervious  cord,  by  the  organization 
of  the  clot ;  and  for  this  reason  a  horse  having  suffered  from  it 
should  not  be  turned  out  to  grass,  as  the  collateral  circulation 
seems  to  be  insufficient  to  convey  the  blood  from  the  head  whilst 
it  is  kept  in  the  depending  position  during  grazing ;  and  as  a 
consequence  much  serum  is  effused  into  the  areolar  tissue  of  the 
face,  cheeks,  lips,  and  nostrils,  interfering  with  the  process  of 
mastication ;  and  by  diminishing  the  calibre  of  the  nostrils,  pre- 
venting the  due  admission  of  air  into  the  lungs. 


DIFFUSE  PHLEBITIS. 

This  originates  from  irritation  of  a  vein,  as  from  punctured 
wounds  in  their  vicinity,  or  it  may  supervene  on  the  circum- 
scribed form,  the  barrier  to  the  admission  of  the  pus — already 
described — giving  way  from  some  cause.  The  symptoms  differ 
from  those  of  the  circumscribed  form  by  extension  of  the  swell- 
ing along  the  course  of  the  vein,  sw^elling  of  the  lymphatics, 
acute  oedema,  and  tension  of  the  par^  resembling  an  erysipela- 
tous inflammation. 

In  acute  diffuse  phlebitis  the  inflammation  extends  along  the 
lining  membrane ;  fibrinous  deposits  are  formed  in  various 
parts,  and  even  in  the  right  side  of  the  heart.  In  other  cases, 
where  the  progress  of  the  disease  is  slower,  the  joints  become 
affected  by  purulent  deposits. 

Wherever  there  is  extensive  venous  circulation,  as  in  the 
lungs,  liver,  joints,  and  intermuscular  areolar  tissue,  there 
venous  congestion  and  eff'usion  take  place ;  inflammation  and 
abscesses  follow.      The  following  case  may  advantageously  be 


574  DISEASES  OF  THE  HEAD,  NECK,  VEINS,  ETC. 

here  noted : — A  mare,  whilst  being  fastened  to  the  carriage,  ran 
away ;  the  carriage  was  caught  by  a  protruding  wall,  and  she  was 
thrown  with  violence,  the  elbow  and  arm  being  lacerated  exten- 
sively. The  wounds  were  treated  with  care.  On  the  third  day 
the  patient  commenced  to  shiver ;  the  swelling  increased  to  a 
great  extent,  the  leg  down  to  the  foot  having  the  appearance  of 
a  tense  oedematous  infiltration,  the  shoulder  and  neck  rapidly 
assumhig  the  same  condition ;  the  breathing  became  hurried, 
the  pulse  rapid  and  feeble ;  the  appetite  entirely  left  her ;  and 
from  this  time  she  rapidly  sank,  and  died  in  two  days.  The 
post  mortem  revealed  the  lungs  in  a  state  of  excessive  con- 
gestion, and  permeated  almost  throughout  with  commencing 
suppuration;  the  cavae,  jugular,  axillary,  radial,  brachial, 
humeral,  metacarpal,  and  even  plantar  veins  of  that  side  were 
found  inflamed  throughout,  their  coats  congested,  thickened, 
and  surrounded  by  a  semi-purulent  fibrinous  deposit,  whilst 
fibrinous  clots  were  found  within  them.  The  elbow,  knee,  and 
fetlock  joints  were  highly  inflamed,  and  contained  much 
unhealthy  synovia.  The  onset  of  phlebitis  is  characterised  b}' 
a  fit  of  rigor,  succeeded  by  great  constitutional  disturbance  and 
the  symptoms  already  mentioned. 


THROMBUS. 

Occasionally  after  the  operation  of  bleeding  there  is  extravasa- 
tion of  blood  into  the  areolar  tissue  surrounding  the  puncture, 
including  considerable  swelling  of  the  parts;  this  is  called  a 
thrombus,  and  is  caused  by  the  operator  drawing  the  skin  too 
far  out  whilst  introducing  the  pin ;  by  the  opening  in  the  skin 
being  too  small  to  allow  the  free  escape  of  the  blood,  or  by  the 
vein  being  loosely  attached  to  the  surrounding  parts,  and  rolling 
during  tlie  operation.  However,  no  bad  consequences  follow  if 
the  opening  be  closed,  a  cold  wet  sponge  held  to  the  part  for  a 
short  time,  and  the  animal's  head  tied  to  the  rack. 

VARICOSE  VEINS 

Are  not  frequently  seen  in  the  lower  animals.  Occasionally 
the  jugular  presents  a  varicose  dilatation  after  it  has  been  bled 
from,  as  if  its  coats  had  been  weakened  at  the  part  by  the 


VARICOSE  VEINS.  57o 

operation.  The  sapliena  is  sometimes  dilated  by  pressure  of  a 
"  bone-spavin,"  or  by  very  prominent  cuneiform  bones.  A  case 
of  a  very  large  varix  on  the  course  of  the  saphena  was  published 
in  the  Edinhurgh  Veterinary  Review,  by  Mr.  Hunt,  Birmingham. 

The  veins  of  the  extremities  of  horned  cattle  present  varicose 
dilatations  along  their  course  in  the  form  of  sacculated  or 
knotty  protuberances  on  various  parts  of  the  vessels ;  the  con- 
tained blood  is  at  first  in  a  fluid  state ;  but  an  alteration  not 
unfrequently  occurs,  the  blood  coagulates,  and  the  vessel 
becomes  obstructed. 

The  formation  of  these  coagula  is  an  effect  of  inflammation 
in  the  coats  of  the  vein ;  this  inflammation  may  be  slight,  or  it 
may  run  on  to  suppuration,  giving  rise  to  small  abscesses.  I 
have  repeatedly  met  with  this  form  of  phlebitis  in  cattle  under- 
fed and  kept  in  wet,  cold  situations.  It  seems  to  arise  from 
debility  of  the  circulation,  and  relaxation  or  want  of  tone  in  the 
coats  of  the  vessels. 

The  treatment  for  dilatations  without  inflammation  : — 
Better  food,  warmth,  and  comfort;  tonics,  and  pressure  by 
bandages;  and,  in  addition,  when  suppuration  is  established, 
the  abscesses  are  to  be  opened,  and  blisters  applied,  but  no 
pressure. 

If  a  large  varix,  without  any  tendency  to  inflammation  and 
formation  of  a  clot,  should  be  met  with  by  the  veterinary  practi- 
tioner, the  vein  is  to  be  obliterated ;  and  the.  method  at  present 
adopted  is  to  introduce  two  needles,  one  above  and  one  below 
the  dilatation,  kept  in  these  positions  by  a  thread  tied  around 
them  so  as  to  cause  mediate  pressure  on  the  venous  coats.  The 
needles  are  not  removed,  but  allowed  to  ulcerate  their  way 
through.  Care  must  be  taken  not  to  introduce  the  needles  into 
the  vein,  but  underneath  it,  so  as  to  ensure  that  the  circulation 
is  absolutely  cut  off. 

PHLEBOLITES. 

Fhlebolites  or  Vein-Stones. — Concretions  have  been  found  in 
dilated  veins  in  the  neck,  and  other  parts.  They  are  formed 
by  the  calcareous  degeneration  of  coagula,  and  are  composed  of 
the  phosphates  of  lime  and  magnesia.  An  interesting  case  is 
reported  in  Morton's  work.  On  Calculous  Co7icretions. 


576  DISEASES  OF  THE  HEAD,  NECK,  VEINS,  ETC. 


ENTRANCE  OF  AIR  INTO  VEINS. 

Air  rapidly  injected  into  a  vein  causes  immediate  death,  but 
if  injected  slowl)'  it  only  causes  great  distress.  The  accidental 
admission  of  air  into  the  veins  has  often  resulted  in  a  fatal 
termination,  and  advantage  has  been  taken  of  the  knowledge  so 
gained,  for  the  purpose  of  destroying  old  or  otherwise  w^orthless 
horses  by  this  easy  mode  of  death.  An  accidental  admission  of 
air  into  a  vein,  causing  death,  may  occur  after  bleeding ;  for 
example,  if  the  pressure  upon  the  jugular  which  is  maintained 
by  the  finger  or  vessel  containing  the  blood  be  suddenly  with- 
drawn, a  vacuum  is  formed,  into  which  the  air  rushes  with  a 
hissing,  gurgling,  or  sucking  sound.  The  animal  is  suddenly 
seized  with  symptoms  of  faintness  and  convulsive  breathing, 
falls,  and  perhaps  immediately  dies.  In  other  instances  the 
fatal  termination  is  not  so  rapid,  but  a  great  faintness  seems  to 
overcome  the  animal.  He  may  fall  and  breathe  with  difficulty ; 
a  churning  noise  is  said  to  be  heard  at  the  heart,  the  action  of 
which  is  extremely  feeble.  If  the  quantity  of  air  which  has 
entered  is  but  small,  the  animal  may  rally ;  but  more  copious 
entrance  causes  death  by  syncope ;  in  some  cases  there  are 
convulsions,  whilst  in  others  death  seems  to  be  due  to  mere 
exhaustion. 

The  mode  of  death  is  as  follows : — The  blood  becoming 
mingled  wdth  air,  assumes  a  frothy  character  in  the  right 
ventricle ;  it  is  sent  through  the  pulmonary  artery,  but  becomes 
more  or  less  arrested  in  the  pulmonic  capillaries,  in  consequence 
of  the  right  ventricle  being  unable  to  overcome  the  mechanical 
obstacle  presented  by  air-bubbles  in  these  vessels.  The  quantity 
of  blood  transmitted  through  the  lungs  for  the  systemic 
circulation  grows  less  and  less,  according  to  theincrease  of 
obstruction  and  arrest  of  the  blood  in  the  capillaries  of  the 
lungs.  The  suj)ply  to  the  head  is  inadequate  to  afford  due 
stimulus  to  the  nervous  centres,  and  syncope  results.  If  circu- 
lation be  not  restored,  this  continues;  tlie  resj^iratory  move- 
ments then  cease,  and  life  becomes  extinct;  the  heart  last 
failing  in  its  action  from  want  of  its  necessary  stimulus — the 
blood. 

From  some  experiments  made  by  me  and  one  of  my  pupils 
(Mr.  Hutcheon),  it  was  found  that  some  of  the  air  w^as  eliminated 


ENTRANCE  OF  AIR  INTO  TEINS.  577 

into  the  areolar  tissue  of  the  lungs,  constituting  interlobular 
emphysema,  and  that  the  inspiratory  movement  was  performed 
with  greater  difficulty  than  the  expiratory. 

Tlie  Cause. — "  Owing  to  the  tendency  to  the  formation  of  a 
vacuum  in  the  pericardium  during  inspiration,  there  is,  during 
that  process,  a  suction  action,  called  by  some  '  venous  inspira- 
tion,' in  the  veins  within  and  near  the  thorax,  extending  to  a 
limited  extent  only,  and  ceasing  where  the  coats  of  the  veins 
collapse.  The  space  in  which  this  suction  action  exists  is  that 
in  which  venous  flux  and  reflux  are  perceptible.  Accordingly, 
it  is  found  that  the  accident  has  always  occurred  when  veins 
have  been  opened  in  the  cervical  and  brachial  regions." — 
(Spence.) 

To  prevent  the  occurrence  of  this  accident,  after  the  operation 
of  phlebotomy,  it  is  only  necessary  to  remove  the  pressure  from 
the  vein  slowly  and  carefully;  but  should  it  occur,  and  not 
prove  immediately  fatal,  the  treatment  should  be  directed  to 
maintain  an  adequate  supply  of  blood  to  the  head.  For  this 
purpose  stimulants  are  to  be  administered ;  and  if  the  animal 
falls,  he  is  to  be  kept  in  the  recumbent  position ;  frictions  are  to 
be  applied  to  the  extremities ;  and  should  the  urgent  symptoms 
pass  away,  the  treatment  is  to  be  conducted  with  the  view  of 
preventing  the  occurrence  of  inflammation  of  the  lungs,  a  sequel 
which,  experience  has  shown,  is  apt  to  ensue. 

The  subject  has  been  carefully  investigated  by  a  commission 
appointed  by  the  French  Academy,  and  by  the  labours  of 
Magendie,  Amussat,  Wattman,  and  Cormack. 


2p 


CHAPTEE  XXXIII. 

DISEASES  OF  THE  ARTERIES  AND  LYMPHATICS. 

DISEASES    OF    THE    ARTERIES ARTERITIS EMBOLISM ANEURISM 

TRUE  ANEURISM THE  DISSECTING  ANEURISM FALSE  ANEU- 
RISM  ANEURISMAL  VARIX VARICOSE  ANEURISM DEGENERA- 
TION   OF    THE    ARTERIAL    COATS CALCAREOUS,    CARTILAGINOUS, 

AND  FATTY  DEGENERATION INJURIES  TO  ARTERIES INFLAM- 
MATION OF  THE  ABSORBENTS. 

ARTERITIS. 

Inflammation  of  the  arteries  is  a  rare  affection  in  the  lower 
animals.  Cases  of  inflammation  of  the  iliac  arteries  are,  however, 
recorded,  and  I  have  seen  instances  of  it.  There  is  a  fine  speci- 
men in  the  College  Museum,  and  the  history  of  the  case  from 
which  it  was  obtained  is  contained  in  the  following  letter : — 

Letter  from  the  late  Professor  Barloio  to  Dr.  Gairdner, 

•'  1  PiLRiG  Street,  12th  December  1855. 

"  My  Dear  Sir — I  have  recently  met  with  a  few  instances 
in  which  arteries  of  considerable  size  have  been  almost  entirely 
plugged  up  with  fibrinous  clots,  firmly  adherent  to  their  walls. 
In  these  cases,  during  life,  there  was  sometimes  visible,  but 
unexplained,  atrophy  of  certain  muscles  in  regions  specially 
supplied  by  such  vessels ;  and  sometimes,  when  a  main  trunk, 
such  as  the  aorta  posterior,  became  thus  plugged,  there  was 
palsy  of  the  hind  parts  (of  course,  I  speak  of  the  horse).  At 
first  I  fancied  these  things  to  possess  no  material  interest,  and 
did  not  preserve  the  vessels.  However,  this  day  week,  a  jjony 
gTcatly  disabled  behind,  but  not  completely  paralytic,  was 
lirought  for  dissection.  I  found  a  large  plug  of  adherent  fibrine 
in  the  aorta  post.,  just  where  this  vessel  divides  into  two  iiiacs 
on  each  side.     (In  the  horse,  you  will  remember,  there  is  uo 


ARTERITIS.  579 

common  iliac,  but  the  aorta  post,  divides  into  internal  and 
external  iliacs).  This  plug  was  firmly  adherent  to  the  roof  of 
the  artery;  that  is,  to  that  part  lying  in  contact  with  the 
vertebrae.  It  w^as  not  sufficiently  large  to  obstruct  the  stream 
of  blood  completely,  but  it  must  have  caused  a  material  lessening 
of  the  stream.  The  internal  iliacs,  however,  were  completely 
plugged  up,  and  the  outside  of  the  fibrinous  clot  was  adherent 
to  their  walls — in  many  places  all  the  way  round.  In  one 
place  especially,  a  calcifying  process  is  taking  place  in  the 
coagulum.  If  such  things  are  not  already  too  familiar  to  you, 
I  wish  you  would  look  in  at  Clyde  Street  any  day  before  two 
P.M.,  for  the  condition  is  to  me  somewhat  new. — Yours  very 
truly,  John  Barlow." 

In  all  the  instances  recorded  of  arteritis  in  the  horse,  the 
disease  w^as  of  a  chronic  and  limited  character,  invading  a  por- 
tion, more  or  less  in  extent,  of  one,  or  at  most  two,  large  arteries 
and  their  branches.  The  diffuse  suppurative  arteritis  described 
by  writers  upon  human  surgery,  so  far  as  my  knowledge  extends, 
is  quite  unknown.  Arteritis  is  generally  caused  by  an  injury, 
though  such  may  not  generally  be  traceable.  The  iliac  arteries, 
and  more  especially  their  branches,  are  imbedded  in  very  powerful 
muscles,  and  during  the  violent  contractions  of  those  muscles 
are  liable  to  be  injured,  the  result  of  the  injury  being  inflam- 
mation ;  exudation  from  the  walls  of  the  vessel,  forming  the 
nucleus  of  a  clot ;  the  clot  being,  as  in  phlebitis,  composed  of 
lymph  exuded  from  the  walls  of  the  vessel,  and  of  coagulated 
blood.  The  formation  of  the  coagulum  always  begins  at  some 
definite  fixed  spot,  and  points  to  some  source  of  local  irritation  ; 
Irom  this  it  extends  until  the  artery  is  plugged  up  to  its  origin 
from  the  parent  trunk. 

The  symptoms  of  plugging  of  the  external  iliacs  are  coldness 
of  the  extremity,  with  muscular  debility,  which  increases  wdth 
exercise,  and  atrophy  of  them ;  and  should  the  arteries  of  both 
sides  be  plugged,  the  symptoms  simulate  those  of  paraplegia.  The 
diagnostic  sign,  however,  is  absence  of  pulsation  in  the  artery, 
detectable  by  examination  per  rectum.  The  loss  of  blood 
supply  to  the  extremity  furnished  ly  these  arteries  is  not 
sufficient  to  cause  gangrene ;  a  modified  circulation  being 
maintained  by  branches   of  other  arteries,  which  anastomose 


580  DISEASES  OF  THE  ARTERIES  AND  LYMPHATICS. 

with  those  of  the  occluded  vessels.  The  want  of  circulation  is 
scarcely  shown  during  repose ;  there  seems  to  be  but  a  slight 
degree  of  muscular  debility ;  but  when  the  animal  is  compelled 
to  move,  he  immediately  exhibits  signs  of  inability. 

Virchow,  in  his  w^ork  on  Cellular  Patliology,  describes  the 
process  of  the  coagulation  of  the  blood  in  the  vessels  under  the 
term  "  thrombosis^  A  clot  so  formed  he  calls  a  thrombus,  and 
the  impulsion  or  projection  onward  of  a  clot  or  thrombus, 
detached  from  the  walls  or  valves  of  the  vascular  system,  is 
described  by  him  under  the  term  "  embolism." 

Thrombi  may  be  propelled  from  the  heart  to  the  arterial 
peripheric  vessels,  or  they  may  form  in  veins  and  travel  to  the 
heart. 

He  says : — "  As  long,  however,  as  the  thrombus  is  confined 
to  a  branch  vessel,  so  long  the  body  is  not  exposed  to  any 
particular  danger ;  the  worst  that  can  happen  is,  that,  in  con- 
sequence of  a  peri  or  meso  phlebitis,  an  abscess  may  form  and 
open  externally.  Only,  the  greater  number  of  thrombi  in  the 
small  branches  do  not  content  themselves  with  advancing  up  to 
the  level  of  the  main  trunk,  but  pretty  constantly  new  masses 
of  coagulum  deposit  themselves  in  the  blood  upon  the  end  of 
the  thrombus,  layer  after  layer;  the  thrombus  is  prolonged 
beyond  the  mouth  of  the  branch  into  the  trunk  in  the  direction 
of  the  current  of  the  blood,  shoots  out  in  the  form  of  a  thick 
cylinder  farther  and  farther,  and  becomes  continually  larger 
and  larger.  Soon  this  prolonged  thrombus  no  longer  bears 
any  proportion  to  the  original  thrombus  from  which  it  proceeds. 
From  a  lumbar  vein,  for  example,  a  plug  may  extend  into  the 
vena  cava  as  thick  as  the  last  phalanx  of  the  thumb. 

"  It  is  these  prolonged  plugs  that  constitute  the  source  of 
real  danger,  as  the  stream  of  blood  may  detach  minute  portions, 
hurry  them  away  with  it,  and  wedge  them  tightly  into  the 
nearest  system  of  arteries  or  capillaries. 

"  Many  cases  of  sudden  death  that  would  otherwise  be 
inexplicable,  are  thus  accounted  for."  The  question  is  one  of 
importance  to  the  veterinarian,  and  is  well  worthy  of  further 
study. 

In  the  human  subject  clots  occasionally  originate  from  very 
trivial  local  causes,  chilblains  even  being  the   starting-point. 


AKTEKITIS. 


581 


May  not  causes  as  trivial  as  this  operate  in  producing  fatal 
results  in  the  lower  animals  ? 

I  think  that  in  no  case  of  swelled  legs,  enlarged  glands, 
subacute  inflammation,  or  hardening  over  the  course  of  the 
lymphatics  or  superficial  veins,  should  the  possibility  of  a  fatal 
termination  by  embolism  to  the  right  side  of  the  heart  be  over- 
looked, or  the  possible  supervention  of  suppurative  phlebitis. 
Professor  Gamgee,  in  his  Doinestic  Animals  in  Health  and 
Disease,  mentions  a  case  of  embolism  supervening  upon  the 
insertion  of  a  seton  for  the  cure  of  bone-spavin. 

In  farcy — a  disease  where  the  lymphatics  are  inflamed — 1 
have  invariably  discovered  coagula  in  the  splenic  vessels,  these 
having  been  originally  formed  in  the  veins  closely  connected 
with  the  inflamed  lymphatics,  conveyed  to  the  heart  in  small 
detached  particles  by  the  returning  stream  of  blood,  propelled 
from  thence  into  the  arterial  system,  and  deposited  in  the 
capillaries  of  the  spleen  and  other  organs.  In  epizootic 
cellulitis — a  disease  characterised  "by  diffuse  inflammation  of 
areolar  tissue — death  frequently  occurs,  when  the  animal  is  to 
all  appearance  recovering,  from  embolism  to  the  right  side 
of  the  heart;  whilst  in  other  instances  of  the  same  disease  the 
thrombi  have  been  propelled  from  the  heart  to  the  cerebral 
arteries,  and  death  has  resulted  from  coma,  or  from  a  slow 
degenerative  disease  of  the  brain,  ensuing  from  deficient  blood 
supply. 

ANEURISM, 

A  pulsating  tumour  containing  blood,  and  communicating  with 
the  interior  of  an  artery. 

Aneurisms  are  divided  into  true  and  false.  "  A  true  aneu- 
rism is  that  which  is  due  to  disease  of  the  arterial  texture, 
whether  the  diseased  condition  be  a  degeneration  and  dilatation 
of  all  the  coats  of  the  vessel,  or  an  ulceration  of  one  or  more  of 
them,  leading  to  dilatation  of  the  external  fibrous  coat. 

"  A  false  aneurism  is  nothincj  more  or  less  than  a  wounded 
artery,  the  blood,  prevented  from  escaping  externally,  becoming 
coagulated  in  the  areolar  tissue,  which  becomes  condensed,  and 
forms  a  sort  of  cyst,  though  generally  a  very  imperfect  one. 
as  in  some  cases  the  force  of  the  blood-current  dissects  the 
textures  widely.     The  wound  in  the  artery  remains  open,  and 


582  DISEASES  OF  THE  ARTERIES  AND  LYMPHATICS. 

enlarges  by  degrees,  so  that  pulsation  is  in  tliis  case  also  a 
marked  feature  in  the  tumour." — (Spence.) 

Many  cases  of  aneurism  in  the  horse  are  recorded,  and  most 
commonly  aneurisms  of  the  anterior  mesenteric  artery  and  pos- 
terior aorta  have  been  met  with.  The  accompanying  drawino-, 
which  is  taken  from  a  specimen  in  the  possession  of  Professor 
Walley,  will  illustrate  the  common  situation  of  aneurism. 


Fig.  111. — Aneurism  of  the  posterior  aorta,  with  calcareous 
degeneration  of  the  walls  of  the  sac. 

a,  Aorta,  natural  size. 

h.  Small  dilatation,  with  the  cut  ends  of  the  anterior  mesen- 
teric and  coeliac  axis. 

c,  Large  aneurismal  sac,  laid  open. 

There  are  records  of  scattered  cases  of  aneurism  in  larc^e 
numbers,  but  the  most  interesting  memoir  bearing  on  this  sub- 
ject appeared  in  the  Vienna  Quarterly  of  Veterinary  Science 
for  1852,  by  Dr.  Bruckmllller.  It  refers  to  aneurism  of  the 
anterior  mesenteric  artery.  Hering  was  the  first  to  indicate 
the  frequency  of  this  lesion,  but  Gurlt  doubted  the  correctness 
of  Bering's  observations.  Bruckmiiller  examined  carefully, 
from  the  22d  May  to  the  30th  September  1851,  65  horses, 
with  a  view  to  determine  the  frequency  of  this  aneurism,  and 
found  only  six  animals  perfectly  free  from  it;  59,  or  91  per 
cent.,  had  dilatation  of  the  mesenteric  artery  to  a  greater  or 
less  extent.  In  19  cases  there  w^as  simple  thickening  of  the 
arterial  coats,  without  or  with  very  slight  dilatation ;  8  small 
aneurisms  from  the  size  of  a  pea  to  a  hazel  nut ;  29  larger, 
varying  from  the  size  of  a  walnut  to  that  of  a  hen's  Qgg ;  and 
3  with  hardening  of  the  coats.  The  ages  of  the  animals  varied 
from  six  to  twenty,  chiefly  from  six  to  eleven.  Aneurism  is 
therefore  not  a  very  rare,  but  a  very  common  disease  in  the 
horse  ;  and  in  a  number  of  cases  of  mesenteric  aneurism  parasites 
are  found  occupying   recesses   in   the   thickened   coats.      The 


ANEUmSM.  58 


o 


parasite  is  a  variety  of  tlie  Strongylus — Strongylus  armahis, 
varietatis  minoris — which  is  often  found  in  the  textures  of 
solipeds. 

With  reference  to  the  presence  of  parasites  in  the  anterior 
mesenteric  artery,  I  may  state  that  they  are  scarcely  ever 
absent  in  the  ass,  and  that  the  coats  of  the  vessel,  as  well  as 
those  of  the  coeliac  axis,  are  thickened — calcareous — and  pre- 
sent aneurismal  dilatations. 

In  the  investigation  of  obscure  causes  of  disease  in  the  horse, 
it  may  be  of  advantage  to  bear  in  mind  the  frequency  of 
aneurism. 

In  the  dog  I  have  witnessed  cases  of  aneurism  of  the  posterior 
aorta,  and  the  symptoms  are  much  better  developed  than  in  the 
horse.  In  the  dog  suffering  from  this  form  of  aneurism,  the 
pulsations  of  the  vessel  can  be  felt  by  laying  the  hand  upon  the 
walls  of  the  abdomen ;  in  fact,  the  expansion  and  contraction  of 
the  artery  (pulsations)  can  be  both  seen  and  felt ;  a  thrill  is  also 
communicated  to  the  pulsations  of  the  femorals.  In  addition 
to  this  diagnostic  sign,  the  animal  suffers  from  marasmus, 
debility  of  the  muscles  of  the  hind  limbs,  loss  of  appetite,  and  a 
tendency  to  vomition. 

Treatment. — Aneurism  of  the  aorta,  mesenteric,  iliac,  or  other 
deep-seated  artery,  is  beyond  the  reach  of  surgical  interference ; 
in  the  dog  I  have,  however,  seen  beneficial  results  follow  the 
persistent  administration  of  the  iodide  of  potassimn.  But  in 
the  more  external  aneurisms,  should  the  veterinarian  meet  with 
such  an  affection,  the  treatment  is  by  continuous  pressure,  or  by 
ligature,  and  in  veterinary  practice  the  operation  of  Hunter  is 
the  best.  The  Hunterian  operation  is  performed  by  tying  the 
artery  on  the  cardiac  side  of  the  tumour,  at  some  distance  from 
the  tumour  where  the  artery  is  most  accessible,  and  where  its 
coats  are  most  free  from  disease.  After  the  operation,  the 
aneurismal  tumour  is  gradually  diminished  by  absorption ;  and 
with  rec^^ard  to  the  main  trunk  on  which  the  aneurism  is  seated, 
it  has  been  found  in  human  surgical  practice  that  it  has  become 
obliterated  from  the  first  branch  above  the  ligature  to  the  first 
below  the  aneurism. 

The  method  of  operation  by  acupressure  is  now  generally 
practised  by  surgeons.  The  employment  of  the  catgut  suture 
is  also  highly  spoken  of.     The  catgut  is  dissolved  after  a  certain 


584  DISEASES  OF  TKE  ARTERIES  AND  LYMPHATICS. 

time,  and  removed  by  absorption,  without  causing  the  ulceration 
which  follows  the  common  tliread  suture. 

The  changes  that  occur  in  an  artery  after  it  has  been  tied  are 
as  follows  : — Plastic  exudation  takes  place  from  the  extremities 
of  the  middle  and  inner  coats  at  the  line  of  deliqiiiation,  with 
exudation  into  the  areolar  tissue  surrounding  the  artery.  Its 
different  coats  can  no  longer  be  distinguished ;  and  sooner  or 
later,  by  means  of  a  thin  exudation  of  lymph  exterior  to  the 
portion  of  coagulum  formed  by  the  coagulation  of  the  blood,  the 
walls  of  the  artery  and  the  surrounding  areolar  tissue  become 
condensed  into  one  mass,  in  which  original  parts  can  no  longer 
be  distinguished ;  and  by  the  organization  of  this  exudation  into 
tibrous  tissue  the  artery  becomes  permanently  obliterated. 

THE  "DISSECTING  ANEURISM," 

Is  fortunately  a  rare  variety  even  in  the  human  being.  This 
form  of  aneurism  is  due  to  rupture  of  the  internal  and  middle 
coats  of  the  artery,  which  allows  the  blood  to  escape  outwards 
and  to  burrow  under  the  external  coat,  separating  it  from  the 
middle  coat,  so  as  to  form  a  cavity,  extending  in  some  cases  for 
a  considerable  distance  in  the  course  of  the  vessel,  and  involving 
more  or  less  of  its  circumference.  It  is  generally  met  with  in 
the  aorta,  and  is  a  cause  of  much  agony. 

Aneurism  of  a  large  artery,  such  as  the  aorta  or  mesenteric, 
may  cause  sudden  death  by  rupture  of  the  arterial  coats ;  the 
symptoms  being  those  common  to  all  excessive  haemorrhages, 
namely,  rapid  sinking  of  the  vital  powers,  pallor  of  the  mucous 
membranes,  coldness  of  the  surface  of  the  body,  extremities, 
and  mouth, — the  animal  generally,  before  dying,  emitting  a 
peculiar  shriek  of  agony. 

FALSE  ANEURISMS. 

Traumatic  or  false  aneurisms  may  be  diffuse  or  circumscribed. 
In  the  diffuse  the  blood  becomes  extravasated  in  the  tissues, 
forming  a  sort  of  flattened  mass  over  the  vessel,  which  com- 
municates to  it  a  feeling  of  pulsation. 

In  the  circumscribed,  the  areolar  tissue  surrounding  the 
opening  in  the  artery  becomes  condensed,  so  as  to  form  a  sac 
which  limits  the  effused  blood. 


ANEUEISMAL  VARIX.  685 


ANEURISMAL  VARIX. 

Wlien  a  direct  communication  is  accidentally  or  otherwise 
made  between  an  arterial  and  venous  trunk,  a  disease  may  be 
formed  which  is  called  "  aneurismal  varix!'  It  may  occur  on 
any  part  where  an  artery  and  vein  in  proximity  to  each  other 
are  both  wounded.  Three  wounds  are  made  before  the  disease 
takes  place ;  for  example,  an  aneurismal  varix  may  occur  from 
venesection,  especially  when  the  blood  is  drawn  from  the 
jugular ;  a  large  fleam  being  used,  or  a  lancet  plunged  too 
deeply,  the  vein  is  wounded  on  each  side,  and  the  carotid 
artery  is  penetrated ;  the  wound  upon  the  outer  side  of  the 
vein  may  heal,  but  that  on  its  inner  side  and  that  in  the 
carotid  may  remain  open,  and  through  these  openings  a  com- 
munication is  established  between  the  two  vessels.  The  effects 
of  this  direct  ingress  of  the  arterial  blood  into  the  vein  causes 
the  latter  to  become  widened,  and  to  present  sac-like  dilata- 
tions; the  artery  on  the  distal  side  of  the  disease  becomes 
smaller,  and  its  coats  thinner,  whilst  on  the  proximal  side  of 
the  wound  it  is  usually  widened. 

The  symptoms  of  aneurismal  varix  are  the  swelled  condition 
of  the  vein,  the  feeble  pulsation  of  the  artery  beyond  the  seat  of 
the  disease,  and  a  thrill  or  hruit  being  perceptible  when  the  part 
is  auscultated. 

This  form  of  aneurism  calls  for  no  special  remarks  as  to  treat- 
ment. Horses  were  very  often  affected  with  it  in  the  days  of 
excessive  and  repeated  bleedings,  and  they  seemed  to  suffer  no 
inconvenience. 


VARICOSE  ANEURISM 

Differs  from  the  last  form  of  false  aneurism  by  the  communica- 
tion between  the  two  vessels  being  indirect;  thus,  the  blood 
escaping  from  a  wound  in  the  artery  passes  into  the  surrounding 
areolar  tissue,  which  it  distends  into  a  sac,  and  from  this  sac 
it  is  discharged  into  a  vein. 

In  the  treatment  of  false  aneurism,  especially  the  diffuse  form, 
the  flow  of  blood  into  the  tissue  must  be  arrested  by  cutting  down 
on  the  tumour,  clettjiing  out  the  coagula,  and  tying  the  artery 
uj)on  both  sides  of  the  wounded  point.     In  small  wounds  of 


&86  DISEASES  OF  THE  ARTERIES  AND  LYMPHATICS. 

arteries,  and  where  the  tumour  is  circumscribed,  a  bandage, 
in  situations  where  it  can  be  firmly  applied,  may  sufi&ce  to 
arrest  the  haemorrhage  and  produce  the  closure  of  the  wound  in 
the  vessel. 

I  have  repeatedly  seen  cases  of  diffuse  aneurism  from  a  wound 
of  the  external  thoracic  artery,  accidentally  inflicted  by  the 
point  of  the  scissors  whilst  the  horse  was  being  "  clipped,"  the 
areolar  tissue  at  the  lower  part  of  the  chest  being  loose,  and 
admittins^  a  lar^e  amount  of  blood,  a  h\me  tumour  has  been  thus 
Ibrmed  in  a  short  time,  requiring  active  interference.  In  such 
cases  the  practitioner  must  "  cast  "  the  animal,  and  operate  on 
the  artery  in  the  manner  already  described. 


DEGENERATIVE  DISEASES  OF  THE  ARTERIAL  COATS. 

There  are  three  forms  of  degeneration  of  the  arterial  coats  fre- 
quently met  with  in  the  horse.  Earely,  indeed,  is  an  old  subject 
dissected  at  the  College  without  some  change  being  detected  in 
the  coats  of  some  of  the  large  arteries. 

The  most  common  form  is  "  calcareous  degeneration."  In  the 
figure  shown  at  page  582  this  change  had  taken  place  to  some 
extent.  The  seat  of  the  calcareous  change  is  the  transverse 
fibres  of  the  middle  coat,  in  which  it  appears  in  the  form  of 
spicula  or  plates,  involving  a  greater  or  less  extent  of  vessel,  and 
in  some  specimens  it  is  so  complete  as  to  convert  the  affected 
part  into  a  mere  passive  tube.  In  consequence  of  this  change 
in  the  middle  coat,  the  external  surface  of  the  artery  presents  an 
uneven  appearance,  unequally  dilated  at  some  parts,  and  slightly 
contracted  at  others.  The  internal  coat  may  be  unclianged  at; 
the  commencement,  but  it  soon  becomes  shrivelled,  irregular,  and 
ruptured  at  the  margins  of  the  deposit. 

In  old  horses  this  change  is  very  common  in  the  pos- 
terior aorta,  anterior  mesenteric,  the  arteries  of  the  extremi- 
ties, the  coronary  (cardiac),  and  arteries  of  the  brain.  Indeed, 
the  so-called  "staggers"  of  old  horses  is  mostly  due  to  this 
degenerative  change  in  the  cerebral  arteries,  or  death  from 
apoplexy  may  be  due  to  rupture  of  a  cerebral  artery  which  has 
been  thus  rendered  friable  and  easily  ruptured. 

Calcareous  deposition  differs  from  true  bone  in  important 
particulars ;  it  is  without  fibrous  structure  and  vascularity ;  it 


DEGENERATIVE  DISEASES  OF  AIITERIAL  COATS.  587 

presents  an  irregular  granular  appearance,  and  is  destitute  of 
obvious  arrangement. 

Chemically,  it  is  composed  of  the  phosphate  and  carbonate  of 
lime,  and  animal  matter  (Lassaigne),  and  it  constitutes  one  of 
the  various  examples  of  that  calcareous  degeneration  common 
to  old  age,  which  is  displayed  in  the  increasing  proportions  of 
earthy  matters  in  various  parts  of  the  animal  body. 

cartilaginous  degeneration. 

Cartilaginous  deposits  are  chiefly  found  in  the  small  arteries, 
at  a  considerable  distance  from  the  heart,  and  present  themselves 
in  various  forms  of  transparency,  consistency,  and  connection 
with  the  inner  membrane. 

They  are  deposits  upon  the  inner  membrane,  and  in  some 
instances  are  easily  peeled  off,  leaving  the  membrane  entire ;  at 
other  times  they  are  firmly  adherent  to.  it.  "  The  only  changes 
wliich  they  seem  to  undergo,  after  assuming  a  cartilaginous  con- 
sistency, is  increase  of  thickness." — (Pirrie.)  "  They  originate 
in  the  exudation  of  arteritis,  which  is  at  first  of  a  gelatinous  con- 
sistence, but  gradually  becomes  firmer,  and  eventually  supplants 
the  inner  membrane,  on  the  free  surface  of  which  it  was  origi- 
nally effused." — (Bizot.) 

FATTY  OR  ATHEROMATOUS  DEGENERATION. 

Fatty  metamorphosis  of  the  arterial  coats  is  rarely  met  with 
in  comparison  to  the  calcareous  form,  but  it  may  be  witnessed 
in  the  coronary  (cardiac)  and  in  the  cerebral  arteries  of  old 
horses,  such  as  old  favourite  carriage-horses,  wliich  have  led  a 
life  of  ease  and  good  living ;  and  very  lately  I  met  with  this 
condition,  along  with  atrophy  and  fatty  degeneration  of  the 
ventricular  walls,  in  the  heart  of  a  brewer's  horse,  which  for 
some  years  had  done  little  or  no  work.  This  form  of  degenera- 
tive disease  consists  of  a  deposition  of  fatty  granules  of  a  pale 
yellowish  colour,  situated  between  the  middle  and  inner  coats  of 
the  artery.  Later  on,  the  coats  of  the  vessel  have  a  thickened 
leathery  appearance,  due  to  degenerative  changes  having  taken 
place  in  all  its  tissues,  by  which  its  power  of  contractility 
is  more  or  less  destroyed,  and  if  it  be  cut  open,  well-marked 


588  DISEASES  OF  THE  AKTEEIES  AND  LYMPHATICS. 

patches  of  a  yellowish  colour  will  be  found  scattered  on  its 
inner  surface,  whilst  deposits  of  earthy  matter  alternate  with 
the  fat. 

I  have  seen  gangrene  of  the  tail  in  cows,  particularly  old  cows. 
May  it  not  have  been  due  to  this  condition  of  the  arterial  coats  ? 
The  subject  is  w^ell  worthy  of  further  consideration. 


INJURIES  TO  ARTERIES. 

In  the  lower  animals  wounds  of  arteries  are  fortunately  rare. 
When  an  artery  is  wounded  the  haemorrhage  is  much  more  rapid 
than  from  a  vein ;  the  blood  is  of  a  bright  red  colour,  and  dis- 
charged in  jets,  synchronous  with  the  contraction  of  the  heart. 
At  first  the  stream  is  full,  and  is  pushed  from  the  wound  with 
considerable  force ;  but  as  the  animal  grows  faint  the  jerks  are 
more  perceptible,  and  the  flow  diminishes.  When  an  artery  is 
torn  it  is  unequally  lacerated ;  its  external  coat  is  tmsted  and 
drawn  out,  whilst  the  divided  internal  and  middle  ones  retract, 
and  are  thrown  towards  the  centre  of  the  canal.  The  elasticity 
and  vitality  of  all  the  coats  are  impaired  for  some  little  distance 
from  the  wound,  and  the  current  of  blood  in  the  injured  part  is 
diminished  or  altogether  arrested  for  some  distance,  and  the 
bleeding  is  thus  prevented. 

If  an  artery  be  split  in  a  longitudinal  direction  and  across  the 
course  of  the  circular  fibres,  the  bleeding  is  most  profuse  when 
the  part  is  relaxed ;  but  if  it  be  kept  on  the  stretch,  the  bleed- 
ing becomes  less  profuse.  If  an  artery  has  been  cut  partially  in 
a  transverse  direction  the  bleeding  is  very  profuse,  for  the  trans- 
verse fibres  separate  from  each  other,  and  the  opening  gapes. 
Cutting  an  artery  completely  across  is  attended  with  its  retrac- 
tion within  the  sheath  and  surrounding  tissue,  and  the  bleeding 
is  arrested  if  the  vessel  is  not  large.  Thus,  when  the  palatine 
artery  has  been  partially  divided,  the  haemorrhage  continues  ; 
but  if  the  incision  be  made  deeper,  and  the  artery  completely 
cut  across,  the  bleeding  gradually  ceases. 

In  the  case  of  a  large  artery,  however,  this  proceeding  is  not 
sufficient,  although  the  bleeding  may  be  arrested  as  the  animal 
grows  faint,  the  pressure  of  the  surrounding  clot  being  sufficient 
at  the  time  to  arrest  the  bleeding ;  but  no  sooner  does  the  faint- 
ness  pass  away,  and  the  circulation  become  strong  again  (unless 


INJURIES  TO  AETERIES.  589 

a  clot  has  formed  within  the  artery,  from  effusion  of  lymph  and 
coagulation  of  the  blood),  than  secondary  hsemorrhage  occurs. 
A  large  artery,  when  divided,  ought  to  be  secured  by  ligature,  or 
acupressure  upon  both  sides  of  the  wound ;  for  if  it  be  secured 
on  the  cardiac  side  only,  the  bleeding  will  continue  by  the  flow 
of  the  blood  being  re-established  through  the  medium  of  the 
collateral  and  anastomosinor  branches. 

The  methods  of  arresting  hgemorrhage,  particularly  if  the 
wounded  vessel  or  vessels  be  small,  by  the  application  of  styptics, 
or  the  actual  or  potential  cautery,  are  very  successful ;  and  they 
act  by  producing  a  clot,  which  may  be  temporary  only,  but 
before  it  is  cast  off  the  natural  haemostatic  process  has  time  to 
be  completed. 

"  The  actual  cautery  should  be  applied  at  a  red  heat  only,  not 
at  a  white  heat,  lest  the  slough  should  separate  too  soon.  The 
cautery  slightly  impairs  the  vital  functions  of  the  coats  of  the 
vessel  at  the  injured  point,  a  clot  forms,  and  the  circulation  is 
arrested." — (Spence.) 


LYMPHANGITIS,  OR  INFLAMMATION  OF  THE  LYMPHATICS. 

This  affection  resembles  bilious  erysipelas  in  the  human  being, 
and  is  known  among  horsemen  by  a  variety  of  terms.  In  Scot- 
land it  is  called  a  "  weed ;"  in  England  a  "  shot  of  grease," 
"  shake,"  and  "  Monday  morning  disease." 

Inflammation  of  the  absorbents  is  usually  confined  to  one 
hind  leg ;  occasionally  both  hind  legs  are  simultaneously  or  suc- 
cessively affected,  and  more  rarely  the  fore  limb,  generally  the 
right — off — is  the  seat  of  the  disease. 

The  local  inflammation  is  commonly  preceded  by  a  shivering 
fit — rigor — which  may  continue  for  some  hours ;  and  as  a  rule 
the  severity  of  the  attack  is  denoted  by  the  intensity  and  dura- 
tion of  the  rigor.  The  rigor  is  accompanied  by  more  or  less 
restlessness ;  and  lameness  in  the  affected  limb  is  manifested 
at  an  early  stage.  To  the  rigor  a  hot  stage  succeeds.  The 
animal  now  blows,  sometimes  with  great  intensity,  whilst  sweats 
bedew  the  body;  the  pulse  is  hard,  full,  and  strong,  the 
accompanying  fever  being  of  the  "  sthenic  type ;"  the  visible 
mucous  membranes  injected,  bowels  constipated,  the  secretion 
of  urine  scanty,  the  urine  high-coloured,  and  loaded  with  hip- 
purates  and  urea. 


590  DISEASES  OF  THE  AKTERIES  AND  LYMPHATICS. 

The  local  inflammation  is  manifested  by  swelling  of  the 
inguinal  glands  when  it  is  in  a  posterior  extremity,  and  of  the 
brachial  glands  wdien  a  fore  limb  is  affected ;  the  swollen  glands 
are  very  painful  when  pressed  npon,  and  a  swelling  extends 
downwards  from  them,  first  as  a  narrow  elevation  upon  the 
inner  side  of  the  thigh  or  arm,  but  soon  extending  in  every 
direction ;  it  involves  the  whole  circumference  of  the  limb,  from 
the  glands  first  inflamed  down  to  the  foot.  As  the  swelKng 
increases,  the  pain  and  lameness  subside. 

Mr.  Haycock,  wdio  was  the  first  to  give  this  disease  a  scien- 
tific name,  very  graphically  describes  a  case  of  it  which  occurred 
in  his  practice.  He  says : — "  The  horse  is  standing  in  the  stable 
on  three  legs,  the  left  hind  limb  being  held  with  the  foot  from 
the  ground.  Great  anxiety  is  depicted  on  the  animal's  coun- 
tenance, and  he  frequently  looks  round  at  the  limb  held  up. 
The  respirations  are  forty-eight  per  minute ;  the  pulse  ninety-six, 
and  hard  and  cord-like  to  the  touch.  The  nostrils  are  dilated  to 
their  full  extent,  and  the  perspiration  rolls  in  drops  from  the 
sides  of  the  abdomen,  the  shoulders,  and  the  thighs.  The  affected 
limb  is  greatly  distended  upon  its  inner  surface,  from  its  junc- 
tion with  the  body  to  the  very  foot.  The  lymphatic  glands  are 
swollen  into  large  lumps  or  masses,  and  towards  them,  in  all 
directions,  run  a  great  number  of  lymphatic  vessels,  enlarged 
to  the  size  of  a  thick  quill.  These  enlarged  vessels  exist  on 
the  outer  as  well  as  the  inner  side  of  the  limb.  The  surface  of 
the  swelling  is  covered  with  a  serous  exudation ;  the  mouth  is 
dry  and  clammy ;  and  great  desire  is  evinced  for  cold  water." 
The  horse  lived  for  two  years  after  the  attack,  the  limb  remain- 
ing thicker  than  natural.  At  the  end  of  that  time  Mr.  Hay- 
cock had  the  opportunity  of  dissecting  the  affected  limb,  and 
he  describes  its  condition  as  follows : — "  On  the  removal  of  the 
skin  from  the  hind  extremities,  I  at  once  observed  a  difference 
in  the  colour  of  the  exposed  structures.  The  fascia  of  the  dis- 
eased limb  was  covered  with  a  yellow-coloured  fluid,  not  unlike 
as  though  the  tissue  liad  been  coated  over  with  a  quantity  of 
bile,  or  very  yellow  serum.  On  cutting  deeper,  I  perceived  the 
areolar  tissue  to  partake  of  the  same  colour,  and  a  yellow  liquor 
exuded  from  it ;  the  tissue  itself  was  also  changed ;  it  was 
dense,  thicker,  and  partook  niore  of  a  fibrous  character  than 
natural.     This  change  w^as  observable  in  all  the  areolar  tissue 


LYMPHANGITIS.  591 

of  the  limb;  at  least,  all  that  I  examined.  The  lymphatic 
glands  were  also  greatly  enlarged ;  and  on  cutting  into  their 
substance,  the  knife  met  with  considerable  resistance  ;  a  scirrhous 
structure  was  exposed ;  the  yellow  fluid  flowed  forth  in  abun- 
dance ;  and  on  carefully  exposing  the  vessels  which  terminated 
in  the  glands,  and  slitting  them  up,  the  same  kind  of  liquor 
was  liberated.  The  internal  surface  of  the  vessels  presented 
here  and  there  patches  of  a  light  red  colour ;  and  on  comparing 
the  vessels  with  those  of  the  other  limb,  they  were  without 
doubt  larger ;  many  of  them  were  double  the  size  in  calibre." 
— (Haycock's  Contributions  to  Veterinary  Pathology)  One  re- 
markable symptom  was  observable  in  the  foregoing  case  that  is 
rarely  witnessed,  namely,  the  visible  enlargement  of  the  lym- 
phatics after  the  accession  of  the  swelling  of  the  limb.  In  all 
the  cases  that  have  fallen  under  my  notice,  the  enlargement  of 
the  absorbents,  though  undoubtedly  present,  has  been  hidden 
or  masked  when  the  areolar  tissue  has  become  swollen. 

Horses  that  have  once  been  attacked  by  lymphangitis  are 
liable  to  a  recurrence  of  the  malady,  and  generally  one  attack 
succeeds  another  periodically,  until  the  limb  assumes  an  enlarged 
or  distended  condition  termed  elephantiasis, — a  state  in  which 
it  is  found  that  the  areolar  tissue  of  the  limb  has  become 
hypertrophied  by  the  organization  of  some  portion  of  the  ex- 
udate formed  at  each  successive  attack. 

Inflammation  of  the  lymphatics,  unless  when  excited  by  a 
specific  poison,  such  as  the  morbid  material  of  glanders  and 
farcy,  seldom  runs  on  to  the  formation  of  pus.  Occasionally, 
however,  the  lympliatic  glands,  more  particularly  the  inguinal, 
suppurate  and  discharge  the  contained  pus.  Suppuration  of  the 
glands  may  be  suspected  when  lymphangitis  continues  longer 
than  usual,  and  when  the  swelling  extends  along  the  abdomen, 
sheath,  or  mammary  glands.  After  a  time,  the  swelling  in  the 
groin  becomes  more  prominent,  but  it  never  has  very  well 
defined  limits,  appearing  more  as  a  purulent  infiltration  than  as 
a  true  abscess.  As  soon  as  it  can  be  ascertained  that  pus  is 
formed,  the  parts  must  be  freely  laid  open,  a  good  depending 
orifice  being  essential,  for  the  pus  is  apt  to  burrow  into  the 
surrounding  fascia  and  areolar  tissue. 

The  causes  of  lymphangitis  are  irritation  of  the  lymphatic 
glands  by  chyle  rich  in  nutritive  products,  and,  in  some  rare 


592  DISEASES  OF  THE  AETERIES  AND  LYMPHATICS. 

instances,  "blood  in  a  highly  fibrinous  condition  owing  to  meta- 
morphosis of  tissues.  The  first  is  produced  by  over-feeding, 
more  particularly  when  the  animal  is  not  called  upon  to  per- 
form his  ordinary  labour ;  and  the  irritation  commences  in  the 
mesenteric  glands,  for  it  has  been  shown  that  every  meal  which 
is  eaten  produces  a  certain  irritation  in  these  glands ;  the  con- 
stituents of  the  chyle  conveyed  to  them  acting  as  physiological 
stimuli  to  the  gland  substance,  whereby  they  become  enlarged. 
This  irritation  extends  from  the  mesentery,  along  the  chain  of 
lymphatic  ganglia  imbedded  in  the  sub-lumbar  and  deep  inguinal 
resfions  which  connect  the  thoracic  duct  with  the  first  visible 
lymphatic  glands — the  superior  inguinal  ganglion.  The  course 
of  the  disease  supports  this  view  of  its  pathology ;  its  peculiarity 
being  the  way  in  which  it  extends  from  above  downwards ;  the 
extension  downwards  along  the  limb  affected  being  merely  a 
continuation  of  the  process  which  has  already  taken  place  in 
the  glands  within  the  cavity  of  the  abdomen.  In  some  instances 
lymphangitis  is  preceded  by  symptoms  of  intestinal  irritation, 
colicky  pains,  and  constipation  of  the  bowels.  This  latter  con- 
dition is  generally  constant,  unless  in  those  instances,  common 
in  Scotland,  where  the  disease  is  produced  by  over-feeding  on 
green  food,  particularly  upon  rye-grass,  when,  instead  of  consti- 
pation, a  condition  approaching  to  diarrhoea  is  often  w^itnessed. 

"SYlien  the  Ijrmphatics  are  inflamed  in  consequence  of  the 
blood  being  in  a  highly  fibrinous  condition,  brought  about  by 
metamorphosis  of  tissue,  it  will  be  found  that  the  animal  has 
not  been  eating  for  some  days :  in  one  instance  "within  my 
recollection,  sixteen  days  elapsed  before  any  manifestation  of 
lymphangitis.  An  explanation  is  difficult,  and  can  only  be 
arrived  at  by  assuming  that  the  vitality  of  the  animal  was 
supported  by  the  pabulum  derived  from  its  own  tissues ;  and 
that  such  nutrient  material,  being  highly  loaded  with  fil^fiae, 
was  calculated  to  act  as  an  irritant  to  the  glands  and  ducts  of 
the  l}Tnphatic  system. 

Treatment. — In  the  first  stage — that  of  rigor — fomentations 
to  the  affected  extremity,  warm  clothing,  purgatives,  and  at  the 
same  time  allowing  the  animal  to  drink  a  moderate  quantity  of 
water.  The  administration  of  stimulants,  unless  the  rigor  be 
very  continuous,  is  not  called  for ;  indeed,  stimulants  are  apt  to 
be  productive  of  harm,  by  causing  a  powerful  reaction ;   but 


LYMPHANGITIS.  693 

should  the  shivering  persist,  notwithstanding  the  application  of 
warmth,  friction,  clothing,  and  bandages,  moderate  doses  of  spirit 
of  nitre  may  be  administered.  As  a  powerful  stimulant  to 
the  vessels  of  the  skin,  inducing  a  general  warmth  over  the 
surface  of  tlie  body,  I  may  mention  that  tincture  of  arnica, 
in  doses  varying  from  one  to  two  ounces,  can  be  given  with 
advantaofe. 

In  the  second  or  hot  stage,  bleeding  from  the  jugular  is 
generally  recommended.  I  have  experimented  upon  this  matter, 
and  have  arrived  at  the  conclusion  that,  although  moderate 
bleeding  does  no  harm,  it  does  no  good ;  it  neither  modifies  nor 
cuts  short  the  disease ;  and  in  cases  where  the  animal  is  debili- 
tated previous  to  the  attack,  the  withdrawal  of  blood  not  only 
increases  the  severity  of  the  local  inflammation,  but  prolongs  its 
duration  as  well.  Fomentations  to  the  affected  limb,  to  induce 
an  early  swelling,  and  the  administration  of  a  cathartic,  con- 
stitute nearly  all  the  treatment  that  is  required.  After  the 
cathartic  has  operated,  diuretic  remedies  may  be  given  with 
advantage ;  and  should  the  fever  be  very  high,  the  pulse  hard^ 
and  the  animal  showing  signs  of  much  pain  and  restlessness, 
tincture  of  aconite  is  to  be  repeatedly  administered.  Some 
practitioners  are  in  the  habit  of  giving  a  small  cathartic,  and 
sending  the  horse  to  ordinary  work  whilst  suffering  from  this 
malady.  Such  practice  is  irrational,  and  defeats  its  own  object ; 
for  exercise,  though  carefully  regulated,  if  given  early  in  the 
disease,  causes  the  swelling  to  assume  a  permanency  of  character 
wliich  it  is  difficult  to  remove.  Exercise  certainly  dissipates  the 
swelling  at  the  time ;  but  after  the  patient  has  stood  for  a  few 
hours,  the  swelling  returns,  and  it  is  no  less  curious  than  true, 
that  each  fresh  exudation  tends  more  and  more  to  become 
organized. 

The  condition  called  elephantiasis,  or  a  chronic  thick  leg,  is 
difficult  to  treat.  A  large  quantity  of  fibrous  tissue  formed  in 
the  limb  assumes  the  character  and  functions  of  one  of  the 
proper  elements  of  the  part,  and  remains  as  a  permanency. 
Drastic  cathartics,  powerful  diuretics,  iodine,  and  its  salts,  have 
been  given,  but  with  little  or  no  advantage ;  whilst  blisters, 
setons,  and  the  actual  cautery  to  the  hmb  itself  have  been  tried 
with  like  effect.  I  think  much  can  be  done  for  the  prevention 
of  this  condition  by  carefully  feeding  the  animal ;  and  when  it 

2  Q 


594  DISEASES  OF  THE  AETERIE^  AND  LYMPHATICS. 

is  actually  present,  by  avoiding  exercise  or  work,  until  at  least 
the  inflammatory  condition  of  the  part  has  subsided. 

In  chronic  swelled  legs,  large  doses  of  veratrum  are  recom- 
mended by  some  veterinarians.  When  the  swelling  is  due  to  a 
mere  dropsical  effusion,  this  remedy  is  a  most  effectual  one ;  but 
when  the  adventitious  tissue  is  organized,  it  is  useless  to  punish 
the  animal  for  no  possible  good  result. 

The  lymphatic  vessels  may  be  inflamed  from  causes  that  may 
be  traceable  to  some  local  lesion,  as  wounds,  and  particularly 
bruises ;  the  inflammation  of  the  lymphatics  being  denoted  by 
swelling  along  their  course,  their  coats  becoming  thickened  and 
infiltrated  with  exudation.  This  condition  is  notably  produced 
by  saddle  or  harness  galls,  when  the  bruise  may  be  seen 
surrounded  by  swollen  lymphatic  vessels,  running  in  various 
directions,  and  to  the  extent  of  a  foot  or  two,  in  some  instances. 
Again,  a  pricked  or  punctured  foot  may  give  rise  to  inflamma- 
tion of  the  lymphatics,  with  swelling  of  them  both  above  and 
below  the  knee  or  hock  joints,  giving  rise  to  a  difficulty  in 
diagnosis  without  a  thorough  examination  of  the  foot. 

Sympathetic  inflammati^in,  and  even  suppuration  of  the 
lymphatic  glands,  may  also  be  occasionally  witnessed ;  but  they 
call  for  no  special  comment,  nor  any  guidance  for  treatment 
beyond  what  has  already  been  laid  down. 

Suppurative  inflammation  of  the  lymphatics  gives  rise  to 
small  isolated  abscesses  along  their  course,  forming,  as  it  were, 
loci  of  the  disease,  each  of  which  appears  to  serve  as  a  fresh 
focus  of  morbid  action ;  this  may  be  witnessed  in  farcy,  a  disease 
with  which  I  do  not  intend  at  present  to  deal,  and  occasionally 
in  sympathetic  inflammation  connected  with  violent  diseases  of 
the  foot  or  leg. 

During  the  early  stages  of  inflammation  of  the  lymphatics  a 
restricted  and  cooling  diet  is  to  be  prescribed ;  for  the  reasons 
already  laid  down,  that  highly  nutritious  food  is  a  direct 
stimulus  to  the  glandular  system.  After  the  more  acute 
symptoms  have  passed  away,  and  when  debility  supervenes,  the 
animal's  strength  must  be  maintained,  and  the  absorption  of  the 
exudate  encouraged  by  a  well  regulated  nutritious  diet ;  whilst 
the  swollen  limb  is  to  be  strengthened  and  supported  by 
moderately  firm  bandages ;  the  absorption  of  the  exudate, 
stimulated  by  frictions  with  the  hand,  and  some  gentle  stimu- 


LYMPHANGITIS.  595 

lating  embrocation.  Iodine  is  not  specially  called  for  unless  tho 
exudate  assumes  a  callous  or  hard  condition.  If  it  be  remem- 
bered that  the  exudation  and  swelling  are  owing  to  the  irritation, 
and  that  they  will  disappear  like  the  swelling  of  any  ordinary 
inflammation  when  the  irritation  is  removed,  much  difficulty  in 
the  due  application  of  suitable  treatment  wiU  be  overcome,  and 
the  animal  saved  much  needless  pain  and  suffering  from  the 
effects  of  the  so-called  "  absorbent  stimulants." 


CHAPTER  XXXIV. 

HERNIA,  ETC. 

REDUCIBLE — IRREDUCIBLE  AND  STRANGULATED  HERNL^ — UMBILICAL 
OR  EXOMPHALOS — VENTRAL,  INGUINAL,  AND  SCROTAL  HERNI-^ — • 
GUT-TIE  IN  CATTLE.  ' 

HEENLE. 

Abdominal  hemise,  or  ruptures,  are  divided  into  reducible, 
irreducible,  and  strangulated,  according  to  their  condition ;  and 
into  inguinal,  scrotal,  ventral,  unibilical,  and  dia^phragmatic, 
according  to  their  situation. 

REDUCIBLE  HERNIA. 

A  hernia  is  reducible  when  it  can  be  easily  returned  into 
the  abdomen.  It  consists  of  a  soft  fluctuating  swelling,  unat- 
tended with  heat,  pain,  or  even  uneasiness.  It  is  generally 
large  after  a  full  meal,  and  decreases  in  size  when  the  bowels 
are  empty.  When  the  animal  coughs,  it  becomes  tense,  larger, 
and  communicates  a  sudden  impulse  to  the  hand  of  the 
examiner.  Writers  upon  human  surgery  lay  it  down  as  a  rule, 
that  when  the  swelling  is  elastic,  uniform,  and  compressible,  and 
if  its  return  be  sudden,  and  attended  with  a  peculiar  gurgling 
noise,  there  can  be  no  doubt  that  the  hernia  is  formed  of  intes- 
tine. If  the  swelling  be  more  solid  and  uneven,  feeling  doughy 
to  the  touch,  receives  an  impression  from  the  fingers  of  the 
examiner,  and  if  its  return  be  gradual  and  unattended  with  any 
peculiar  sound,  there  can  be  no  doubt  of  its  being  an  omental 
hernia  only ;  if  a  portion  of  the  swelling  be  elastic,  and  returns 
suddenly  with  a  gurgling  noise,  and  if  the  remaining  part  be 


REDUCIBLE  HERNIA.  597 

doughy  and  its  return  be  more  gradual,  the  hernia  is  in  all  pro- 
bability formed  of  intestine  and  omentum. 


IRREDUCIBLE  HERNIA. 

A  hernia  is  said  to  be  irreducible  when  it  is  not  strangulated, 
but  yet  cannot  be  returned  into  the  abdomen.  The  causes  that 
prevent  reduction  are : — 1st.  The  bulk  of  the  protruded  parts 
being  out  of  proportion  to  the  opening  through  which  they 
would  have  to  return.  2d.  Adhesions  of  the  protruded  parts  to 
the  hernial  sac  through  the  medium  of  organizable  lymph,  which 
assumes  the  form  of  filamentous  bands,  admitting  of  some 
degree  of  movement  between  the  intestine  and  sac,  or  a  more 
firm  union,  constituting  what  has  been  called  "  the  fleshy  union." 
In  this  form  the  union  is  close,  firm,  and  deep,  so  that  the  sac 
and  its  contents  cannot  be  separated  from  each  other,  but  form  a 
solid  mass,  the  circulation  of  which  i«  common  to  both  sac  and 
intestines. 


STRANGULATED   HERNIA. 

A  hernia  is  said  to  be  strangulated  when  the  contents  of 
the  sac  experience  such  a  degree  of  pressure  as  not  only  to 
cause  them  to  be  irreducible,  but  also,  by  compressing  their 
blood-vessels,  to  disturb,  impede,  or  suspend  the  circulation 
within  them.  This  condition  speedily  causes  inflammation 
in  the  protruded  parts,  which  extends  to  others  within  the 
abdomen. 


HERNIiE,  AS  NAMED  ACCORDING  TO  THEIR  SITUATION. 

ExoMPHALOS. — A  protrusion  of  any  portion  of  bowel  or 
omentum  through  the  navel,  forming  a  tumour  at  that  part,  is 
called  umbilical  hernia  or  exomphalos.  It  is  very  frequently 
congenital,  and  is  more  commonly  met  with  in  calves  than  in 
foals.  If  not  congenital,  it  generally  takes  place  very  shortly 
after  the  birth  of  the  foal  or  calf,  and  arises  from  the  yielding 
of  the  umbilical  opening  ;  the  closure  of  which,  although  it  may 
be  complete,  is  still  lax  and  weak.  In  some  cases  this  laxity 
and  weakness  remain  until  the  animal  is  two  or  even  three 


59S  HERNIA,  ETC. 

years  of  age,  and  a  rupture  may  happen  from  any  violent 
effort.  This  hernia,  more  especially  in  foals,  is  occasionally 
spontaneously  reduced.  As  the  animal  grows,  the  omentum 
and  mesentery,  being,  in  proportion,  shorter  in  the  adult  than 
in  the  young  animal,  are  drawn  into  the  abdomen,  and  the 
opening  closes. 

Treatment. — The  animal,  having  been  kept  short  of  food  for  a 
few  hours,  is  to  be  cast,  and  the  contents  of  the  sac  carefully  re- 
turned. The  reduction  effected,  the  skin  is  to  be  drawn  from 
the  belly,  pinched  up,  and  confined  in  its  folded  state  by  the 
plain  wooden  clams,  placed  upon  the  sides  of  the  fold,  or  by  two 
skewers  run  through  it  at  each  extremity  of  the  opening  in  the 
abdominal  walls,  and  as  close  as  possible  to  the  surface  of  the 
abdominal  fascia.  The  skewers  are  to  be  connected,  and  the 
doubled  skin  made  into  a  firm  fold  by  a  piece  of  strong  twine 
wrapped  roimd  them,  firmly  but  not  too  tightly,  embracing  the 
folded  skin.  In  applying  sutures,  clams,  or  skewers,  for  the 
reduction  of  hernia,  wherever  situated,  the  objects  to  be  attained 
are,  the  union  of  the  internal  surfaces  of  the  folded  skin,  and 
the  production  of  an  exudate  to  block  up  the  hernial  opening. 
To  do  these  successfully,  the  external  pressure  is  not  to  be  so 
great  as  to  cause  rapid  sloughing  of  the  skin,  but  to  induce 
adhesive  inflammation  of  the  opposing  surfaces.  If  there  be 
occasion  to  tighten  the  ligature  or  apply  a  fresh  one,  there  is  no 
necessity  to  cast  the  animal.  I  recommend  this  method,  as  I 
have  known  of  cases  where  very  tight  ligatures  have  been 
applied,  and  where  the  skin  has  rapidly  sloughed,  result  in 
protrusion  of  the  bowels,  and  death. 

In  calves  the  hernial  sac  frequently  suppurates,  the  skin  and 
surrounding  structures  inflame,  the  animal  goes  off  its  food,  and 
calves  with  such  navels  are  looked  upon  as  bad  thrivers.  When 
means  are  employed  for  the  reduction  of  the  hernia  in  cases  of 
this  description,  the  process  of  consolidation,  after  the  clam  or 
sutures  have  been  removed,  is  not  very  satisfactory,  and  what 
appears  to  be  a  successful  result  in  many  instances  proves 
delusive ;  the  sac  filling  again,  and  perhaps  to  a  greater  extent 
than  before  surgical  interference.  Animals  of  tliis  kind  are  often 
of  a  tuberculous  constitution,  and  a  repetition  of  the  operation 
is  dangerous ;  the  want  of  proper  tone  and  vitality  in  the  parts 
rendering  them  liable  to  excessive  sloughing,  which,  by  exten- 


EXOMPHALOS.  599 

sion  throngli  the  walls  of  the  abdomen,  allows  the  escape  of  the 
intestines,  and  causes  the  death  of  the  animal. 

In  those  cases  where  the  tumour  is  of  a  globular  form,  a  ligature 
round  its  neck  is  often  effectual.  Ligatures,  clams,  sutures,  and 
skewers  must  be  allowed  to  drop  off  spontaneously,  or  the  opera- 
tion may  prove  incomplete. 

FISTULOUS  UMBILICAL  HEKNIA. 

Of  this  form  of  hernia,  with  artificial  anus,  the  following  in- 
teresting case  is  recorded  in  the  Veterinarian  for  1833  by  Pro- 
fessor Dick : — 

The  horse,  four  years  old,  was  bought  at  Kinross  Market, 
with  a  considerable  enlargement  of  the  umbilicus  upon  him. 
He  did  his  work  for  some  time,  but  it  was  with  stiffness  and 
unwillingness.  Shortly  afterwards  he  was  seized  with  a  "  ting," 
and  a  farrier  was  sent  for,  under  whom  he  got  better.  He  was 
put  to  work  again,  but  proved  still  stiff  and  unwilling.  Shortly 
after,  "  an  opening  formed  at  the  navel,  by  which  the  whole  of 
the  faeces  were  passed  off."  Mr.  Thomson,  Y.S.,  Eedstone,  was 
sent  for,  who  "  stitched  up  the  opening,  which  was  large  enough 
to  admit  a  person's  fist,  and  applied  a  roller  with  a  pad  of  tow 
over  it,  also  occasionally  adhesive  plaister."  "Adhesion  took 
place,  and  granulations  formed  very  rapidly  for  some  time  ;  but 
a  very  small  opening  remained,  which  seemed  extremely  obsti- 
nate, yet  was  making  a  little  progress,  and  to  all  appearance 
would  have  been  entirely  closed  in  a  short  time  " — when  he  died. 
The  intestines  proved  in  many  places  perforated  by  ulceration, 
apparently  the  effects  of  lumbrici.  There  seemed  to  be  no 
disease  about  the  umbilical  opening,  except  adhesion  between 
the  intestines  and  the  parietes  of  the  abdomen.  I  found  it  to 
be  a  part  of  the  ileum  that  had  fallen  into  the  opening,  about  a 
foot  from  the  csecum.  Nature  had  formed  a  tube  of  about  two 
inches  long,  quite  distinct  from  the  ileum,  by  way  of  a  rectum ; 
but  when  it  was  a  good  deal  healed  up,  air  seemed  to  be  sucked 
in  by  it,  and  passed  o^  per  anum.  In  drinking,  the  water  passed 
off  by  it  without  any  of  the  aliment  being  mixed  with  it ;  it 
seemed  almost  as  clear  when  passed  as  when  drunk.  If  he  got 
the  benefit  of  his  meat,  he  received  no  benefit  of  his  drink ;  for  it 
passed  off  as  fast  as  he  drank  it ;  and  from  this  cause,  apparently. 


600  HERNIiE,  ETC. 

he  "became  very  much  emaciated.  During  the  time  Mr.  Thom- 
son attended  him  he  showed  no  symptoms  of  disease,  save  a 
slight  attack  of  gripes.  Before  death  the  wound  became  reduced 
to  the  size  of  a  quill,  discharging  white  mucus,  but  no  faeces. 
He  was  allowed  only  two  pints  of  water  a  day,  with  some  pea- 
meal,  with  a  small  quantity  of  hay.  When  Mr  Thomson  first 
saw  the  horse,  he  gave  a  clyster  of  water-gruel,  which  occa- 
sioned much  inconvenience,  "  seemingly  by  emptying  the  pos- 
terior bowels  too  much,  as  flatus  passed,  seemingly  from  the 
orifice  of  the  anus,  and  he  worked  like  a  pair  of  bellows  for  four 
hours."  Mr.  Thomson  then  injected  a  solution  of  sulph.  zinc  at 
the  orifice,  which  caused  griping  pains  for  a  short  time;  but 
they  did  not  recur,  although  this  was  afterwards  frequently 
repeated. 

Analogous  to  the  above  operation  in  principle,  but  simpler  in 
apphcation,  is  one  that  has  been  practised  with  great  success  by 
Mr.  Pattie,  Yoker,  Glasgow.  His  account,  in  the  Veterinarian 
for  1836,  of  his  mode  of  operating  is — "  The  colt  is  not  cast,  nor 
submitted  to  any  restraint  beyond  that  of  having  his  head  held. 
The  hernial  tumour  is  emptied  by  forcing  its  contents  into  the 
the  belly ;  the  loose  integument  forming  the  pouch  is  gathered 
into  the  left  hand,  while  the  right  surrounds  it  by  a  ligature 
placed  as  closely  as  possible  to  the  abdominal  parietes,  and 
drawn  sufiiciently  tight  to  interrupt  the  circulation.  On  the 
second  day  there  is  considerable  tumefaction  around  the  incar- 
cerated integument,  which  also  in  a  slight  degree  partakes  of 
the  engorgement,  feels  cold,  and  often  clammy  and  moist.  When 
the  ligature  has  not  been  sufficiently  tight,  or  the  pouch  so  large 
as  to  require  strong  compression  for  arresting  the  circulation,  it 
is  hot  and  tender.  In  all  cases  more  than  one  ligature  is  neces- 
sary. Generally  on  the  third  day  the  first  cord  is  loose.  The 
cu'cle  it  embraces  has  been  reduced ,  partly  by  absorption  and 
partly  by  incision,  and  there  is  no  longer  any  compression.  If 
neglected  after  this,  the  tuR.our  rapidly  increases  in  size,  and  is 
attached  by  a  neck  whose  diameter  is  limited  by  the  ligature. 
It  is  necessary,  therefore,  to  see  the  patient  twice  or  thrice  a 
week  to  renew  the  ligature.  The  second,  third,  or  fourth,  should 
80  many  be  required,  must  be  placed  above  that  which  preceded, 
and  close  to  the  abdomen.  They  relax  in  from  one  to  tlu"ee 
days,  and  are  then  useless,  save  for  the  purpose,  of  supporting 


FISTULOUS  UMBILICAL  HERNIA.  601 

those  wliicli  follow.  Tlie  whole  drop  off,  along  with  the  tumour, 
in  from  ten  to  twelve  days.  The  place  from  which  the  pouch 
is  detached  is  neither  raised  nor  excavated.  It  is  a  flat,  granu- 
lating surface,  as  large  as  a  halfpenny,  and  seldom  broader  than 
a  half-crown.  IsTo  further  treatment  is  required,  save,  perhaps, 
a  little  astringent  lotion  to  hasten  cicatrisation,  or  an  ointment 
to  exclude  flies." 

VENTRAL  HERNIA. 

Yentral  hernia  differs  from  the  umbilical  and  inguinal  forms, 
from  the  circumstance  of  the  protrusion  occurring  through  an 
artificial  opening  in  the  abdominal  walls,  produced  by  violence, 
and  not  through  natural  apertures,  as  in  the  other  instances. 

A  ventral  hernia  may  be  situated  on  any  part  of  the  abdominal 
parietes,  except  the  navel,  and  is  caused  by  laceration  of  some 
of  the  muscular  or  tendinous  fibres  composing  the  abdominal 
walls.  The  size  of  the  tumour  varies  greatly  in  different  cases  ; 
and  strangulation  of  this  hernia  rarely  occurs.  Sometimes  a 
partial  or  incomplete  ventral  hernia  is  met  with,  namely,  rup- 
ture of  the  outer  layer  of  the  abdominal  muscles,  the  internal 
layer  being  intact. 

Large  ventral  hernias  are  rarely  curable,  but  should  the  mus- 
cular gap  be  small,  the  methods  recommended  for  umbilical 
hernia  may  be  employed  with  success.  In  the  generality  of 
cases  there  is,  however,  no  necessity  for  adopting  any  kind  of 
treatment. 

A  case  of  ventral  artificial  anus  is  recorded  in  the  Veteri- 
narian for  1837,  by  Mr.  Karkeek,  V.S.,  Truro,  which  is  highly 
interesting,  both  on  account  of  its  rarity  and  the  successful  issue 
of  the  treatment  adopted.     Mr.  Karkeek  says : — 

"  Two  years  since  a  pony  mare  received  an  injury  from  the 
horn  of  a  bullock  on  that  portion  of  the  abdomen  situated  be- 
tween the  cartilages  of  the  false  ribs,  inclining  a  little  to  the 
left  side,  producing  a  ventral  hernia  about  the  size  of  a  cricket 
ball.  From  a  kick  received  upon  the  place  from  the  toe  of  the 
shoe  of  a  boy,  very  serious  injury  resulted,  which  terminated 
in  an  opening  through  the  lacerated  muscles  into  the  colon 
itself;  being  that  portion  of  its  second  flexure  which  forms 
the  upper  and  anterior  arch,  and  the  liquid  and  pulpy  contents 
soon  issued  freely  from  the  aperture.     The  mare  continued  for 


602  HERNLE,  ETC. 

three  weeks  in  this  state,  when  I  was  requested  to  examine  her 
— about  the  6th  of  January.  I  found  the  opening  nearly  large 
enough  to  admit  my  four  fingers,  and  it  had  a  very  unhealthy 
appearance.  The  discharge  of  pulpy  and  watery  food  was  great, 
and  the  smell  very  offensive;  so  much  so,  that  it  was  with 
difficulty  any  person  could  be  found  to  attend  her.  The  pulse 
was  between  50  and  60,  and  the  appetite  tolerably  good." — The 
mare  being  with  foal,  and  an  old  favourite  besides,  her  owner 
was  very  desirous  to  have  something  done.  There  were  two 
favourable  circumstances — the  length  of  time  since  the  injury, 
and  the  absence  of  inflammation. — "  Having  cleaned  the  wound," 
says  Mr.  Karkeek,  "  I  closed  the  opening  with  a  strong  suture 
of  pack-thread,  with  a  common  packing  needle,  taking  in  as 
much  of  the  integuments  and  abdominal  muscles  as  possible. 
I  then  applied  a  pledget  of  tow  soaked  in  a  solution  of  chloride 
of  lime,  and  supported  the  wdiole  by  means  of  a  thick  woollen 
bandage  laced  along  the  spine.  I  ordered  the  wound  to  be 
cleansed  and  the  solution  to  be  applied  every  morning,  and  her 
head  to  be  tied  to  the  rack  to  prevent  her  lying  down.  About 
five  weeks  afterwards,  being  in  the  neighbourhood,  I  called  to 
inquire  after  my  patient,  when  to  my  surprise  I  found  her  alive 
and  well,  the  wound  having  completely  healed.  Had  this  case 
happened  nearer  my  residence,  I  should  have  endeavoured  to 
have  instituted  some  experiments  with  regard  to  the  process  of 
digestion  on  dilBPerent  kinds  of  food ;  and  this,  I  believe,  might 
have  been  done  without  endangering  the  life  of  the  animal,  as 
there  was  a  copious  discharge  of  food  for  three  weeks  previous 
to  my  attending  the  mare." 

Professor  Simonds  relates  a  case  of  extensive  ventral  hernia 
in  the  Veterinarian  for  1839,  to  which  the  reader  may  refer. 
The  result  was  most  successful ;  but  as  a  rule  it  is  safer  not  to 
treat  this  form  of  hernia  otherwise  than  by  a  compress  and  sus- 
pensory bandage,  that  can  be  tightened  at  pleasure,  as  there  is 
great  danger  of  sloughing  of  the  skin,  and  consequent  protrusion 
of  the  intestine. 


INGUINAL  HERNIA. 

Inguinal  hernia,  w  huhonocele,  almost  always  makes  its  ap- 
pearance suddenly,  and  hastens  to  become  strangulated.     The 


INGUINAL  HERNIA. 


go: 


contents  of  this  hernia  consist  almost  in  all  cases  of  the  small 
intestines.  From  the  looseness  of  their  attachment,  their  volume, 
their  general  emptiness,  and  their  energetic  contractility,  they 
most  readily  enter  the  inguinal  canal.  The  duplicatures  and 
Hexures  of  the  colon  are  the  parts  next  most  liable  to  protrusion. 
In  respect  to  the  omentum — which  is  so  short  that  one  would 
conceive  it  impossible  it  could  ever  reach  the  canal,  without 
laceration  at  least — its  protru- 
sion is  uniformly  the  effect  of 
some  violent  intestinal  com- 
motion, and  is  never  the  occa- 
sion of  much  mischief.  When 
the  contents  are  intestines 
solely,  the  hernia  is  denomi- 
nated an  Enterocele;  when 
nothing  but  omentum,  Epi- 
2^locele ;  when  both  combined, 
Entero-Epijolocele."  —  (Girard 
on  Inguinal  Hernia.  Paris, 
1827). 

The  lower  animals  are  much 
less  subject  to  this  form  of 
hernia  than  man,  and  this  is 
not  less  due  to  the  position  of 
their  bodies  than  to  the  ar- 
rangement of  the  muscular 
and  fibrous  envelopes  forming 
the  floor  of  the  abdomen.  M. 
Girard  says : — , 

"  In  man,  the  intestinal 
mass  is  bearing  downwards, 
and  particularly  upon  the  in- 
guinal regions,  where  the  open- 
ings— the  abdominal  ring  and 
crural  arch — are  situated.     In 

consequence  of  the  oblique  in-  ^  &,  small  intestine,  which  is  fixed  in  the 

^T      4.  •  o  ^  -I   J  inguinal   canal ;    c,  c,  is    the   neck  of   the 

ClmatlOn,  forwards  and  down-  pe°ritoneal  sheaih,   which  is  enlarged  from 

wards,  of  the  floor  of  the  belly,  the  passage  of  the  intestine  into  it ;  d,  d, 

n  ,1       X3      1    i.     n        1     •  1     i  tnmefied     portion    of     spermatic    cord. — 

from  the  flank  to  the  brisket,  ^ji'rom  Gamgee's  Domestic  Animals.) 


604  HERNIA,  ETC. 

the  intestinal  mass  gravitates  against  the  diaphragm,  pushing  it 
forward  and  occasionally  rupturing  it.  The  resistance  afforded  by 
the  parietes  of  the  belly  is  likewise  greater,  owing  to  the  increased 
density  and  peculiar  disposition  of  the  coverings  of  the  abdomen, 
the  fascia  superficialis  being  thicker,  more  elastic,  and  more  deve- 
loped than  in  man,  and  particularly  towards  the  pubes,  and  being 
supported  by  the  panniculus  carnosus,  an  envelope  that  does  not 
exist  in  man ;  added  to  which — not  to  mention  the  advantages 
arising  from  the  oblique  and  straight  muscles,  which  latter  are 
much  broader  than  in  man — the  fascia  transversalis  is  consider- 
ably stronger  and  more  expanded.  Connect  with  these  facts  the 
practice  of  castration  at  an  early  age,  one  consequence  of  which 
is  the  contraction  of  the  inguinal  canal,  and  there  will  appear 
sufficient  to  account  for  the  comparative  exemption  of  the  horse 
from  inguinal  rupture ;  and  at  the  same  time,  for  the  unheard-of 
occurrence  of  the  species  denominated  femoral."  ^ 

Inguinal  hernia  is  most  frequently  met  with  in  stallions  and 
young  animals,  and  essentially  consists  of  a  passage  of  a  fold  of 
intestine  into  the  inguinal  canal  through  the  internal  abdominal 
ring.  It  is  very  frequently  seen  in  India  and  on  the  Continent, 
but  it  is  uncommon  in  this  country,  from  the  fact  that  stallions 
are  not  often  used  for  working  purposes. 

It  is  but  rarely  seen  in  the  gelding,  and  scarcely  ever  in  the 
mare,  although  it  is  possible  that  it  may  occur  in  both. 

It  occasionally  presents  peculiarities : — 1st.  "  It  may  occur 
with  or  without  visible  tumour ;  and  it  may  either  be  acutCy 
chronic,  simple,  strangulated,  continued,  or  intermittent.  In  some 
cases  there  exists  a  thickening  of  the  membranes,  adhesions  of 

*  ** This  was  written  in  1827,  but  since  then  an  'unheard-of  case  has  happened 
to  M.  Seon,  V.  S.  to  the  Garde  Roydle.  He  was  called,  while  on  the  march,  to  a 
mare  with  a  swelling  as  large  as  his  fist  in  the  upper  and  fore  part  of  the  inside  of 
the  thigh.  The  existence  of  hernia  was  evident  beyond  dispute.  By  compressing 
and  pushing  its  contents  backward  and  upward,  he  caused  the  whole  of  them  to 
re-enter  the  canal,  but  they  speedily  re-appeared.  Bandages  and  compresses  of 
tow  kept  the  hernia  reduced,  but  their  tightness  caused  alarming  tumefactions, 
which  required  their  removal ;  and  the  consequence  was,  on  the  sixth  day  the 
hernia  returned.  The  mare  was  now  cast,  the  hernia  reduced,  and  pledgets  of 
tow,  dipped  in  melted  pitch,  plastered  upon  the  situation  of  the  tumour,  and  over 
them,  one,  twelve  inches  in  diameter,  of  pitched  strong  canvas.  As  soon  as 
the  pitch  had  set,  the  mare  was  let  up.  In  ten  days  afterwards  the  plasters  had 
fallen  off,  leaving  some  ulcerations,  which  readily  healed.  The  place  opposite  the 
termination  of  the  femoral  canal  subsequently  exhibited  a  species  of  callus." — 
(Percivall's  Hippopathology.) 


INGUINAL  HERNIA.  605 

the  coverings  of  the  hernia  to  one  another,  and  occasionally  to 
the  intestine  within  them.  In  other  instances  hernia  is  compli- 
cated with  hydrocele,  the  tumour  assuming  another  shape,  and 
acquiring  considerable  magnitude.  Besides  these  differences,  the 
hernia  may  be  imperceptible,  at  least  to  the  view,  in  consequence 
of  having  protruded  no  further  than  the  inguinal  canal,  in  which 
state  it  is  called  a  Uchonocele  ;  when  it  pervades  the  canal  and 
descends  into  the  scrotum  it  takes  the  appellation  of  oscheocele. 
Either  of  these  forms  may  be  recent  or  chronic,  reducible  or  irre- 
ducible. Hernia  very  rarely  exists  on  both  sides.  It  occurs 
oftenest  on  the  right,  a  circumstance  which  is  not  easily  ex- 
plained."— (GiKARD  on  Inguinal  Hernia?) 

The  Symptoms. — ^Whenever  a  staUion,  or  even  a  gelding,  is 
affected  with  symptoms  of  colic,  more  especially  if  the  symptoms 
of  abdominal  pain  are  apparently  relieved  when  the  animal  is 
laid  upon  his  back,  a  position  he  will  maintain  for  half-an-hour 
or  more  at  a  time,  it  is  the  duty  of  the  veterinary  surgeon  to 
examine  for  hernia.  This  is  done  by  first  emptying  the  rectum 
of  its  contents  by  an  enema,  and  then  exploring  the  internal 
abdominal  ring,  by  passing  one  hand  into  the  rectum,  and  mani- 
pulating the  scrotum  with  the  other  hand.  The  strangulated 
intestine  can  be  easily  felt  should  the  hernia  exist.  If  the  hernia 
is  not  reduced,  the  symptoms  increase  in  severity,  the  pain  be- 
comes continuous,  cold  sweats  bedew  the  body,  more  especially 
the  scrotum  and  thighs ;  the  animal  sighs,  the  pulse  becomes 
thready,  the  eyes  injected,  and  the  pupils  dilated. 

The  indications  of  the  presence  of  an  inguinal  hernia  before 
actual  strangulation  has  taken  place  are,  according  to  Mr.  Perci- 
vall,  as  follows ; — "  Indisposition  to  work,  erected  head,  appetite 
impaired,  pain  succeeding ;  the  aninml  breathes  deeply,  paws, 
and  puts  himself  into  various  postures  to  obtain  relief.  There 
are  cases  in  which  the  horse  appears  as  if  he  were  languishing 
from  over-fatigue.  Now  and  then  the  gut  returns  of  itself,  and 
the  patient  becomes  suddenly  restored  to  ease.  A  second 
descent,  however,  commonly  takes  place,  and  that — should  it 
likewise  return — becomes  followed  by  a  third,  and  so  on,  until, 
from  the  volume  it  acquires,  the  hernia  becomes  permanent. 
The  testicle  on  the  hernial  side,  though  felt  drawn  up, 
irregularly  descends  and  ascends.  This  symptom  is  highly 
pathognomonic,  and  one  demanding  that  the  practitioner  should, 


606 


HERNLE,  ETC. 


without  loss  of  time,  examine  into   the  state  of  the  inguinal 
canal." 

The  following  account  of  scrotal   hernia   I  have  taken  the 
liberty  of  transcribing  from  Percivall's  Hippo]3atliology : — 


Fig.  ]13. — Scrotal  hernia,  showing  at  a  a  the  fold  of  intestine  in 
the  scrotum  ;  c  c  is  the  wall  of  the  hernial  sac  ;  e  represents  the 
elevation  of  the  tunica  vaginalis  produced  by  the  testicle. — (Girard.) 


SCROTAL  HERNIA,  OR  OSCHEOCELE, 

"  Owes  its  production  to  dilatation  of  the  vaginal  sheath  of  the 
testicle,  combined  with  relaxation  of  the  fibrous  tissue  surround- 
ing the  ring,  and  is  at  first  mostly  intermittent;  that  is,  it 
disappears  during  repose,  and  returns  under  exercise  or  exertion  ; 
which  variable  condition  continues  until  such  a  descent  takes 


SCROTAL  HERNIA.  607 

place  as  renders  the  tumour,  from  its  weight,  incapable  of 
yielding  to  the  retraction  of  the  surrounding  parts;  in  this 
condition  its  augmentation  goes  on,  until  the  matters  accumu- 
lated within  the  gut  produce  obstruction,  and  that  becomes 
followed  by  strangulation.  These  changes,  so  far  from  being- 
sudden,  proceed  rather  slowly ;  and  accumulation  and  obstruc- 
tion always  precede  strangulation.  While  the  accumulation  is 
going  on,  we  may  observe  loathing  of  food,  dulness,  indisposition 
to  move ;  also,  as  the  engorgement  proceeds,  loss  of  appetite^, 
constipation,  borborygma,  colic.  Strangulation  adds  virulence 
to  these  symptoms,  occasioning,  as  in  recent  hernia,  the  greatest 
distress,  until  gangrene  takes  place,  and  then  all  pain  suddenly 
ceases,  and  cold  sweats ;  shiverings  and  convulsions  close  the 
scene. 

"  Strangulation. — Practical  observations  show  us  that  old  herniae 
become  strangulated  from  engorgement,  and  not  from  stricture 
around  the  neck  of  the  sac  at  the  ring ;  that  can  be  considered 
but  as  a  secondary  cause.  The  circumstance  of  stricture  fol- 
lowing, however,  accounts  for  the  symptoms  of  strangulation 
being  in  these  and  the  afore-mentioned  cases  essentially  alike ; 
being  found  to  vary  only  in  their  succession  and  rapidity  of 
progress.  It  may  be  observed,  however,  that  many  horses  having 
scrotal  hernise  not  only  escape  strangulation,  but  continue  to  do 
their  work  with  a  large  tumour  swinging  between  their  thighs ; 
Gibson  mentions  a  case  in  which  "  the  gut  extended  the  scrotum 
down  to  the  hock,"  apparently  without  any  inconvenience  from 
it,  beyond  what  may  arise  from  its  bulk  and  weight.  This  is  a 
fact  which  argues  most  strongly  against  meddling  with  such 
tumours  unless  we  be  peremptorily  called  on  to  interfere. 

"  Diagnosis. — It  is  not  always  easy  to  distinguish  scrotal  enter- 
ocele  from  other  swellings  of  the  genitals,  and  particularly  when 
the  hernia  is  complicated  with  sarcocele  or  variocele,  or  thickening 
of  the  cord,  or  a  combination  of  these  affections.  The  tumour 
of  an  enterocele  does  not  preserve  a  general  uniformity ;  it  is 
commonly  most  bulky  next  the  abdomen,  increasing  from  below 
upwards ;  indeed  there  are  cases  in  which  its  volume  below 
little,  if  any,  exceeds  that  of  the  scrotum.  The  swelling  yields 
to  pressure,  and  returns  to  its  form  after  being  compressed.  If  it 
be  raised  up  with  the  hand,  it  sensibly  diminishes  in  volume, 
from  part  of  its  contents  being  withdrawn  into  the  abdomen ; 


608 


HERNLE,  ETC. 


which  retraction  sometimes  is  attended  with  a  gurgling  noise. 
Should  it  be  deemed  advisable  to  examine  into  the  state  of 
the  inguinal  canal,  its  openings  will  be  found  to  be  more  or  less 
dilated  and  encumbered ;  and  this  is  an  infallible  proof  of  the 
existence  of  hernia. 

"  One  diagnostic  more  I  would  add,  which  seems  to  have  escaped 
the  observation  of  our  learned  author;  and  that  is,  the  self- 
expansion  of  the  swelling  under  the  effort  of  coughing.  Grasp 
the  tumour  with  one  or  both  hands,  softly  but  closely,  and  then 
let  another  person  cough  the  horse,  and  the  swelling  will  be 
found  suddenly  to  expand  under  the  effort,  and  as  quickly  to 
recedo  again.  Might  not  this  criterion  supersede  the  trouble- 
some business  of  exploration  per  rectum  et  vaginam  penis  ? 

"  Morbid  Conseqitences. — In  almost  all  chronic  hernise  we  meet 
with  serous  effusion,  either  into  the  cavity  of  the  tunica  vaginalis, 
or  into  the  cellular  tissue  uniting  the  hernial  coverings.  Morbid 
thickening  of  the  tunics  is  a  much  rarer  occurrence,  and  one  of 
which  M.  Girard  has  seen  but  few  examples.  The  comparative 
rarity  of  cases  of  adhesion  between  the  gut  and  sac  in  horses, 
(rirard  thinks,  may  be  ascribed  to  the  non-employment  of 
artificial  pressure,  by  trusses  and  bandages,  as  in  man.  Mr. 
Charles  Percivall,  however,  informs  me  that  the  occurrence  is  by 
no  means  so  uncommon  in  India,  where  castration  is  much 
practised  at  a  late  ^period  of  life!' 

CONGENITAL  SCROTAL  HERNIA. 

This,  the  most  frequent,  but  the  least  dangerous  species  of 
hernia,  is  an  attendant  on  birth,  augmenting  up  to  the  third  or 
sixth  month,  after  that  diminishing,  and  ultimately  disappearing. 
Should  it  continue  without  lessening  in  volume  for  a  year 
or  eighteen  months,  it  may  be  considered  as,  and  is  in  fact 
become,  a  chronic  or  permanent  scrotal  hernia.  In  case  the 
swelling,  however,  instead  of  being  always  the  same,  at  intervals 
diminishes,  and  continues  so  to  do,  more  sensibly  as  time 
advances,  it  will  in  the  end  recede  altogether ;  and  though  it 
return  again  at  times,  still,  the  relapses  growing  less  marked  or 
frequent,  at  last  the  gut  will  enter  the  ring  no  more. 

In  the  foetus  in  utero  inguinal  hernia  is  found.  M.  Linguenard, 
y.S.,  who  has  practised  for  twenty  years  in  ^N'ormandy,  a  great 


CONGENITAL  SCROTAL  HERNIA.  609 

breeding  country,  has  ascertained,  by  a  vast  number  of  observa- 
tions, that  inguinal  hernia  is  invariably  present  at  birth,  even  in 
abortions  and  in  subjects  still-born. 

After  hirth. — Hernise  making  their  appearance  a  few  days  after 
birth  are  also  to  be  included  in  the  class  of  "  congenital."  In 
these  cases  the  gut  becomes  hernial  in  the  same  manner  in  which 
it  does  in  adult  age  ;  it  slips  through  the  peritoneal  aperture  at 
the  ring,  and  either  drags  down  the  testicle  along  with  it,  or  else 
follows  that  organ  in  its  descent ;  the  testicles  in  ordinary  cases 
not  descending  prior  to  the  sixth  or  seventh  month.  The  experi- 
enced practitioner  above  named,  M.  Linguenard,  calculates  that 
about  one-fourth  of  the  Norman  colts  are  foaled  with  scrotal 
hernia ;  but  that  in  the  majority  of  them  it  disappears  in  the 
course  of  growth.  In  the  Recueil  de  Medicine  Veterinaire  for 
July  1828  appears  the  following: — These  swellings  (scrotal 
hernise)  occasionally  make  their  appearance  in  the  scrotum  of 
the  colt  a  few  days  after  birth.  Sometimes  they  occupy  one  side 
only  of  the  bag ;  occasionally  both  are  distended.  In  a  few 
instances  the  scrotum  becomes  as  large  as  a  child's  head :  these 
are  true  scrotal  hernise.  A  portion  of  intestine  has  descended 
into  the  scrotum.  Bandages  and  topical  applications  are  per- 
fectly useless,  or  worse — producing  irritation  and  pain.  At 
an  uncertain  period  the  swelling  begins  spontaneously  to  dimi- 
nish, and  at  length  entirely  disappears.  When  it  occupies 
both  sides  of  the  scrotum,  it  goes  back  more  tardily ;  and  the 
retraction  of  one  side  seems  to  be  quite  independent  of  that  of 
the  other. 

Causes. — It  is  worth  while  to  inquire  if  the  hernise,  prior  to 
birth,  originate  from  causes  similar  to  those  that  occasion  it  in 
after  age.  Certain  movements  of  the^  full-grown  foetus  appear 
very  likely  to  produce  hernia,  especially  at  a  time  when  the 
inguinal  apertures  and  passes  are  so  lax  as  almost  to  invite 
entry;  indeed,  both  the  ring  and  inguinal  canal  in  the  foetus 
appear  proportionably  larger  than  in  the  adult,  and  evidently 
possess  more  extensibility.  The  parietal  parts — the  fibrous 
aponeurosis  of  the  abdomen,  the  borders  of  the  external  ring, 
the  dartos,  and  the  cremaster — being  all  as  yet  but  imperfectly 
developed,  possess  little  power  to  oppose  hernia.  No  sooner  has 
the  foetus  left  the  womb,  however,  than  these  several  parts  by 
degrees  acquire  strengtli,  until  they  attain  energy  sufficient  to 

2ii 


610  HERNIA,  ETC. 

react  upon  an  incarcerated  hernia,  raise  it  upwards,  and  ulti- 
mately force  it  back  again  into  the  abdominal  cavity  and  retain 
it  there. 

EPIPLOCELE 

Is  a  frequent  companion  of  enterocele,  without  adding  anything 
to  the  importance  of  the  case ;  indeed,  epiplocele  of  itself  is  so 
far  from  being  dangerous  that  it  has  occurred  without  symptoms 
either  of  pain  or  disordered  function.  Protruded  omentum, 
without  intestine,  gives  rise  simply  to  a  soft  indolent  tumour 
in  the  groin,  unvarying  in  volume,  unless  it  receive  additional 
contents — a  circumstance  that  serves  at  once  to  distinguish  it 
from  enterocele.  I  think  I  may  add  to  this  cougliing,  as  a 
corroborating  diagnostic.  M.  Eoupp  assured  M.  Girard  that 
in  the  course  of  the  practice  of  castration  on  cart-horses,  he 
had  on  several  occasions  met  with  hernial  omentum,  and  had 
invariably  amputated  the  protrusion  without  the  slightest  ill 
consequences. 

Tliickening  of  the  membranes  will  render  the  dissection  of  the 
dartos  from  the  sac  both  tedious  and  difficult;  and  this  may 
exist  to  such  a  degree — in  one  case  they  were  found  an  inch  in 
thickness — that  for  the  clams  we  shall  be  compelled  to  substitute 
a  strong  waxed  ligature  for  the  compression  of  the  cord,  which 
should  be  fastened  by  a  running  knot. 

In  the  case  of  sarcocele  the  operator  must  be  guided  by  circum- 
stances. Should  the  tumour  consist  of  intestine  principally,  the 
operation  is  to  be  conducted  the  same  as  for  thickened  mem- 
branes. Sarcocele  may  render  the  tumour  so  firm  and  compact 
as  to  deprive  it  of  every  sign  or  feeling  of  containing  intestine;  and 
should  the  operator  neglect  to  explore  the  ring,  this  concealment 
may  lead  him  into  fatal  error,  in  case  he  might  determine  on 
the  removal  of  the  sarcocele.  Whenever  intestine  is  detected, 
he  must  take  care  to  make  himself  sure  about  its  return  before 
he  ventures  to  apply  either  clams  or  ligature  to  the  sarcocelatous 
swelling. 

Adhesions  between  the  hernial  gut  and  its  sac  are  so  rare 
that  M.  Girard  has  seen  but  one  instance  of  their  occurrence ; 
though  it  would  appear,  from  what  has  been  already  stated,  on 
the  authority  of  Mr.  Charles  Percivall,  that  between  the  testicle 
and  its  vaginal  covering  they  are  by  no  means  uncommon. 


EPIPLOCELE.  611 

"When  adhesions  of  the  first  kind  do  occur,  it  becomes  necessary 
to  open  the  sac,  in  order  to  destroy  them,  before  the  reduction  can 
be  accomplished,  a  case  wherein  the  clams  will  have  to  be  applied 
upon  the  bare  cord. 

In  the  cases  of  stoppage  and  strangulation,  herniotomy  becomes 
necessary,  and  must  be  practised  without  delay;  otherwise, 
scrotal  hernia  in  general  admits  of  time  for  deciding  on  the 
operation,  and  for  preparation  for  it  by  dieting,  blood-letting,  &c. 

After  the  operation,  the  veterinarian  will,  besides  enjoining  a 
low  and  appropriate  diet,  bleed  and  purge  and  administer  injec- 
tions, according  as  the  case  may  seem  to  require.  The  animal 
had  better  stand  with  liis  croup  elevated,  and  be  tied  up  so  that 
he  cannot  lie  down. 

Hernia  in  geldings  is  a  disease  of  the  rarest  kind,  the 
veterinary  annals  of  our  own  country  affording  ample  proof  of 
this ;  but  the  fact  of  there  being  cases  on  record  is  sufficient 
to  show  that  a  case  may  occur,  perhaps  at  a  moment  least  of 
all  expected;  and  that  we  may  not  be  taken  unprepared,  it 
behoves  us  to  possess  every  information  requisite  for  the  treat- 
ment of  such  an  accident. 

In  geldings  inguinal  hernia  takes  the  same  course,  and  is  sus- 
ceptible of  the  same  terminations,  as  in  stallions.  Trusses  and 
bandages  are  all  ineffectual;  a  surgical  operation  is  the  only 
means  of  causing  contraction  and  closure  of  the  inguinal  canal. 
And  this  consists  simply  in  returning  the  bowel,  and  the  appli- 
cation of  clams — no  cutting  being  required — upon  the  outside  of 
the  skin,  the  same  as  is  practised  for  umbilical  hernia. 

Treatment  of  Strangulated,  Scrotal,  and  Inguinal  Hernice  in 
the  Stallion. — If  the  hernia  be  recent,  and  not  very  firmly 
strangulated,  the  intestine  is  returnable  by  manipulation,  even 
without  casting  the  animal ;  but  should  any  difficulty  be  experi- 
enced, the  horse  must  be  cast,  turned  upon  his  back,  and 
maintained  in  that  position,  with  his  croup  raised  by  bundles 
of  straw  properly  adjusted.  The  operator  will  now  introduce 
his  hand  into  the  rectum,  which  has  been  already  emptied  by 
enemas,  and  explore  the  internal  ring,  where  he  will  feel  the 
imprisoned  gut.  He  is  then  to  endeavour  to  disengage  the  hernial 
portion  by  gently  withdrawing  it  into  the  abdominal  cavity,  at 
the  same  time  aiding  its  retraction  by  pushing  it  with  the  other 
hand.     Should  there  be  much  difficulty  in  effecting  the  return 


612  HERXIiE,  ETC. 

in  this  way,  the  practitioner  is  to  desist,  violence  being  too  often 
the  forerunner  of  strangulation  and  gangrene.  This  operation  is 
called  the  Taxis  ;  it  is  recommended  by  M.  Girard,  Mr.  Percivall, 
and  others.  I  am,  however,  of  opinion  that  it  is  very  often  an 
objectionable  method  of  procedure,  endangering  the  animal's  life, 
by  causing  gangrene  of  the  imprisoned  intestine ;  and  from  the 
excessively  lacerable  condition  of  the  rectum,  generally  asso- 
ciated with  hernia,  there  is  great  danger  of  its  walls  becoming 
ruptured,  no  matter  how  careful  the  veterinary  surgeon  may  be. 
It  must  also  be  borne  in  mind  that  although  reduction  may  be 
effected  by  the  Taxis,  without  the  occurrence  of  rupture  of  the 
rectum,  or  the  infliction  of  so  much  injury  to  the  strangulated 
intestine  as  to  cause  gangrene,  notwithstanding  the  opinion  of 
some  practitioners,  I  maintain  that  the  operation  is  incomplete 
unless  it  be  followed  by  castration ;  for,  without  this,  the  protru- 
sion is  likely  to  recur,  and  may  even  do  so  immediately  after 
the  animal  has  risen.  It  is,  therefore,  better  to  castrate  the 
animal,  being  careful  not  to  wound  the  intestine ;  and  the  covered 
operation,  namely,  that  method  by  which  the  tunica  vaginalis 
reflexa  is  left  uncut,  is  that  recommended  by  Percivall  and  others. 
My  own  opinion  on  the  subject  will  be  found  in  the  chapter  on 
Castration. 

The  covered  operation  is  performed  as  follows: — The  skin 
and  dartos  muscle  are  to  be  carefully  separated  from  the  tunica 
reflexa  until  the  hernial  sac  is  fully  exposed  to  view;  an 
incision,  sufficiently  large  to  introduce  the  finger,  is  then  to  be 
carefully  made  into  it.  When  this  is  done,  the  operator  is 
to  pass  his  finger  into  the  opening,  and  discover  the  stricture ; 
then  he  is  to  introduce  a  strong  "  histouri  cache''  along  his 
finger  into  the  stricture,  and  divide  it,  taking  care  to  keep  the 
back  of  the  bistoury  towards  the  imprisoned  bowel.  In  many 
cases  when  the  canal  is  thus  dilated  the  bowel  will  slip  into 
the  abdominal  cavity  with  very  little  trouble;  but  should  a 
large  quantity  of  intestine  be  imprisoned,  it  will  be  necessary 
to  enlarge  the  opening  in  the  tunica  reflexa  to  an  extent  suffi- 
cient to  allow  fhe  bowel  to  be  pulled  out  and  gently  unravelled 
before  it  can  be  returned. 

The  return  being  effected,  the  scrotum,  including  the  skin, 
cord,  and  its  tunics,  are  to  be  enclosed  in  a  plain  clam,  which 
is  to  be  left  on  until  it  sloughs  off.     Without  this  precaution 


OPERATION  FOR  HERNIA  IN  STALLIONS.  613 

tlie  operation  is  unsafe ;  for  the  inguinal  canal,  "whicli  has  by 
the  operation  been  made  sufficiently  large  for  the  incarcerated 
intestine  to  return  to  its  proper  position,  is  by  the  same  opera- 
tion so  dilated  as  to  present  no  impediment  to  a  recurrence  of 
the  protrusion. 

The  constitutional  treatment  of  the  animal,  before  the  opera- 
tion, must  be  conducted  with  a  view  to  allay  pain  and  relax  the 
parts ;  for  this  purpose  large  doses  of  opium  are  to  be  given, 
and  the  operation  may  be  performed  under  chloroform. 

After  the  operation,  fomentations  to  the  abdomen,  repetition 
of  the  opium  until  all  symptoms  of  pain  have  subsided ;  and 
to  prevent  displacement  of  the  clam  and  injury  to  the  scrotum, 
it  is  advisable  to  tie  the  horse's  head  to  the  rack,  giving  him 
very  gentle  walking  exercise. 

Purgatives  are  to  be  avoided  both  before  and  after  the 
operation,  because  excitation  of  the  peristaltic  action  of  the 
bowels  increases  the  contents  of  the-  hernial  sac,  thus  render- 
ing the  return  of  the  gut  more  difficult,  and  by  stimulating  the 
bowels  generally,  converts  the  irritation  of  the  part  into  a 
general  inflammation  of  the  intestines.  A  continuance  of  the 
constipation  produced  by  the  opium  is  not  to  be  feared,  indeed 
it  is  to  be  encouraged  for  a  reasonable  period,  say  three  or  four 
days,  for  it  gives  time  for  the  injured  portions  of  the  bowels  to 
become  restored  to  their  healthy  condition.  Should  the  con- 
stipation extend  beyond  this  time,  and  if  the  practitioner  is 
convinced  that  the  patient  suffers  from  it,  a  very  mild  aperient 
is  to  be  administered — say,  one  pint  of  castor  or  linseed  oil ; 
the  large  bowels  emptied  by  enemas,  and  irritation  of  them 
prevented  by  allowing  none  but  the  simplest  food,  bran  and 
linseed  mashes  being  very  suitable,  and  demulcents,  such  as 
linseed  tea,  to  drink. 

The  hernia  which  sometimes,  immediately  follows  ordinary 
castration,  produced  either  by  the  violent  struggles  of  the 
animal  while  under  the  operation  or  in  the  act  of  rising,  the 
escape  of  the  bowels  being  facilitated  by  a  natural  lax  condition 
of  the  abdominal  rings  and  canal,  is  to  be  treated  like  the  fore- 
going, the  gut  being  first  returned,  when  this  is  possible,  and 
the  scrotum  and  its  contents  included  in  a  plain  (not  caustic) 
clam. 

Mr.  Stanley  of  Warwick,  late  of  the  5th  Lancers,  has  furnished 


614  HERNIJi:,  ETC. 

me  with  the  following  account  of  hernise  as  they  occur  in 
India. 

Inguinal  and  scrotal  hernia  are  frequently  met  with  in  our 
Indian  cavalry,  many  of  the  horses  being  stallions.  No  age, 
breeding,  or  size  is  exempt  or  specially  predisposed ;  but  country- 
bred  coarse  horses  are  more  often  afflicted  with  chronic  hernia, 
probably  because  there  are  more  of  them  entire.  Stud-bred 
English-crossed  are  always  castrated. 

These  forms  of  hernia  are  frequently  met  with  on  the  Con- 
tinent of  Europe,  and  occasionally  in  our  home  breeding 
establishments. 

There  are  two  forms :  1st  The  acute ;  and  2d.  The  chronic. 

Causes. — Fatigue  and  heat  of  climate,  by  relaxing  the  vascular 
and  muscular  fibres,  cause  the  testicles  to  descend,  so  that  the 
scrotum  appears  remarkably  large  and  dependent ;  the  weight 
of  the  glands  thus  gradually  dilates  the  internal  ring,  and  the 
bowel  during  its  vermicular  action  glides  along  the  cord  into  the 
inguinal  canal,  and  on  to  the  scrotum,  constituting  the  affection 
under  consideration.  Hydrocele,  violent  kicking,  severe  exer- 
tion, getting  cast,  are  all  exciting  causes. 

This  affection  in  our  patients  is  incorrectly  termed  rupture, 
because  there  is  no  laceration  of  tissue ;  all  entire  horses  being 
liable  to  it  at  any  time,  as  the  lining  membrane  of  the  scrotal 
sac  is  simply  a  continuation  of  the  peritoneal  membrane  lining 
the  abdomen,  and  reflected  over  the  viscera ;  so  that  there  is  an 
opening  from  the  former  to  the  scrotum,  connected  by  a  passage 
termed  the  inguinal  canal,  the  upper  border  of  which  canal 
(formed  of  peritoneal  membrane)  constitutes  the  internal  abdo- 
minal ring,  which  is  supported  by  the  fascia  of  the  abdominal 
muscles,  through  which  it  passes  by  a  slit-like  aperture.  It  is 
through  this  opening,  or  mouth  of  the  inguinal  canal,  that  the 
herniated  bowel  first  passes  from  the  abdomen  towards  the 
scrotum  ;  and  if  this  opening  is  small,  a  few  inches  of  the  bowel 
become  fixed,  the  ring  acting  as  a  ligature.  The  vessels  of  the 
imprisoned  bowel,  now  in  the  inguinal  canal,  become  engorged, 
gaseous  distension  aggravates  the  mischief,  and  we  have  a  case 
of  acute  inguinal  hernia.  The  symptoms  resemble  those  of  colic 
or  spasm  of  the  bowels,  with  these  additions ;  intense,  uninter- 
rupted abdominal  pain ;  the  testicle  on  the  affected  side,  drawn 
close  to  the  abdomen,  is  not  let  down  on  walking,  and  tlie 


OPERATION  FOR  HERNIA  IN  STALLIONS.  615 

opposite  gland  is  raised  and  lowered  uneasily ;  perspiration  drops 
from  the  scrotum,  the  loins,  and  flanks ;  the  leg  on  the  affected 
side  sometimes  halts  in  walking ;  in  some  cases  it  is  held  up, 
and  the  sufferer  will  bite  at  the  part.  The  pulse  at  first  is 
little  disturbed,  but  it  very  soon  beats  rapidly,  and  gets  hard, 
small,  and  wiry,  indicating  intense  pain ;  the  countenance  is  ex- 
tremely anxious,  breathing,  panting ;  the  patient  is  not  still  an 
instant,  but  up  and  down,  rolling,  and  even  screaming  with 
agony,  and,  later  on,  straining  violently,  as  if  to  void  faeces. 
Examination  per  rectum,  which  should  be  made  in  every  case 
of  doubt  (with  a  little  patient  experience),  will  decide  at  once 
whether  it  be  inguinal  hernia  or  not,  simply  feeling  with  the 
fingers  the  cord  passing  into  the  ring  or  mouth  of  the  inguinal 
canal.  If  it  is  clear,  the  ends  of  one,  two,  or  even  three  fingers 
may  go  into  the  ring;  if  the  bowel  is  there,  the  ring  is  found 
choked  and  the  bowel  fixed,  so  that  it  may  be  taken  hold  of 
and  pulled  (of  course,  to  a  limited  extent),  and  the  patient  will 
instantly  strain  with  all  his  might.  Comparison  with  the  oppo- 
site ring  will  always  decide  the  case. 

Tliis  examination  is  easily  made  while  the  horse  is  standing. 
Nothing  (unless  there  is  a  considerable  length  of  bowel  in 
the  canal — then  its  inferior  border  may  be  defined)  can  be 
seen  or  felt  externally  in  a  purely  inguinal  case.  Unless 
relieved  by  operative  surgery,  death  results  in  from  nine  to 
twelve  hours. 

Post  Mortem. — Having  removed  the  hind  leg  on  the  affected 
side,  on  opening  the  scrotum  bloody  serum  escapes,  and  the 
testicle  is  inflamed.  By  laying  open  the  inguinal  canal,  and 
following  the  course  of  the  cord,  we  find  it  much  swollen, 
highly  inflamed,  and  infiltrated  witb  a  sero-fibrinous  effusion ; 
and  at  the  top  of  the  canal,  close  to  and  just  outside  the  abdo- 
minal wall,  is  a  small  knuckle  of  purplish-black  intestine,  filled 
with  gas,  as  tight  and  hard  as  a  ball.  The  strangulating  ring 
is  simply  peritoneum  inclosing  the  cord  with  this  bit  of  bowel. 
Inguinal  hernia  terminates  more  rapidly  and  fatally  than  scrotal, 
owing  to  the  aperture  of  the  ring  being  so  small. 

Scrotal  hernia  may  be  acute  or  chronic.  The  acute  is  when 
the  herniated  bowel  has  travelled  down  the  inguinal  canal  into 
the  scrotum,  and  strangulation  has  quickly  followed.  The 
symptoms  are  less  acute  in  the  early  stage,  slower  in  progress, 


616  HERNIiE,  ETC. 

and  prove  fatal  a  few  hours  later.  The  remarks  as  to  diagnosis 
in  the  inguinal  form  apply  here,  excepting  that  the  scrotum  is 
full  of  bowel  and  the  canal  distended  by  it.  Nevertheless, 
examination  per  rectum  is  absolutely  necessary  to  confirmation. 

Chronic  scrotal  hernia  is  undoubtedly  more  common  than 
suspected,  and  where  the  ring  has  gradually  become  very  much 
dilated,  is  accompanied  by  very  little  inconvenience  to  the  animal; 
simply  rolling  on  his  back  being  sufficient  to  reduce  the  hernia,  as 
it  slips  back  by  gravitation  into  the  abdomen.  There  was  a  har- 
ness-horse which,  after  trotting  a  few  miles,  always  stopped,  and 
could  not  be  prevented  lying  down,  but  after  having  a  roll  would 
get  up  and  go  on  with  his  work  for  a  time,  and  then  repeat  the  act, 
— all  explained  by  a  scrotal  hernia.  Animals  that  escape  pain 
escape  also  observation  and  detection  of  the  affection.  There  is 
always  danger  of  ingesta  passing  with  the  bowel  into  the 
scrotum,  producing  distension  and  strangulation  ;  but  the  more 
usual  consequence  is  gradual  enlargement  of  the  scrotum,  a 
succession  of  attacks  of  abdominal  pain,  gradual  vital  depression, 
wdth  loss  of  condition,  emaciation,  and  inability  to  work.  Then 
operative  intervention  is  imperative. 

Treatment  of  the  acute  and  strangulated  form  must  be  early 
and  decisive,  and  the  operation  is  one  of  our  greatest  triumphs 
in  veterinary  surgery,  as  the  patient  not  only  recovers,  but  is 
positively  saved  from  a  most  painful  death. 

To  proceed,  give  internally  a  powerful  sedative,  then  secure 
the  horse  on  his  back,  his  feet  being  raised  by  a  rope  thrown 
over  a  beam ;  draw  the  hind-leg  on  the  affected  side  away  from 
the  body,  and  forwards,  so  as  to  relax  the  ring  and  muscles  of 
the  groin ;  hold  the  testicle,  and  manipulate  along  the  cord,  so 
as  to  force  the  bowel  back,  if  possible,  into  the  abdomen.  Valu- 
able assistance  may  be  afforded  by  dragging  on  the  bowel  per 
rectum;  if  the  case  be  chronic,  and  the  canal  and  ring  large, 
reduction  is  readily  effected  in  this  way.  If,  on  the  contrary, 
the  hernia  is  fixed  immoveably,  opening  the  scrotum  and  ampu- 
tating the  testicle  will,  in  some  cases,  assist  reduction,  but  is  not 
recommended,  as  the  bleeding  makes  the  operation  a  very  dirty 
one.  The  simplest  and  most  effectual  method  is  to  cut  down 
on  to  the  inguinal  canal  close  to  the  internal  ring,  making  a 
small  opening  through  its  peritoneal  tunic  just  to  admit  a  finger 
(beware  of  wounding  the  bowel  immediately  beneath).    The 


OPERATION  FOR  HERNIA  IN  STALLIONS.  617 

pressure  of  the  finger  may  suffice  to  return  the  bowel,  but  more 
often,  on  attempting  to  pass  the  tip  of  the  finger  through  the 
ring  to  the  abdomen,  it  will  be  found  so  tight  that  this  is  im- 
possible ;  keep  the  tip  of  the  left  fore-finger  against  the  ring  as 
a  guide ;  slide  a  narrow  guarded  bistoury  along  the  guide  (with 
the  right  hand)  through  the  ring,  with  the  cutting  edge  outwards 
and  forwards  ;  compress  the  handles  as  to  bring  the  sharp  edge 
against  the  ring ;  and  if  properly  done,  its  giving  way  is  in- 
stantly felt ;  remove  the  bistoury,  and  press  the  bowel  from  the 
canal  towards  the  belly.  It  goes  readily  enough,  and  as  the  last 
portion  falls  in  (the  finger  should  feel  round  inside  the  ring  to 
make  sure  all  is  clear),  the  poor  sufferer  gives  a  deep  sigh  of 
relief,  and  from  that  moment  the  pain  ceases.  No  suture  or 
compress  is  necessary ;  the  parts  being  already  inflamed  and 
swollen,  the  wound  will  keep  the  animal  quiet,  and  set  up  suf- 
ficient inflammatory  swelling  and  adhesions  to  prevent  effectually 
the  recurrence  of  the  affection.  By  these  means  the  testicles  are 
spared,  and  a  very  speedy  cure  effected.  Cases  have  returned  to 
work  perfectly  healed  in  three  to  five  days  after  the  operation  ; 
others  have  had  scrotal  abscesses  form,  a  few  weeks  later,  ulti- 
mately making  good  recoveries.  The  subsequent  treatment 
consists  of  sedatives,  purgatives,  enemas  of  tobacco  smoke, 
fomentations,  &c.,  &c.,  as  for  inflammation  of  the  bowels :  in  a 
case  ultimately  successful,  the  bowels  were  not  moved  for  sixty 
hours. 

It  is  almost  impossible,  and  indeed  would  require  an  in- 
strument a  foot  long,  to  cut  through  the  ring  by  passing  a 
bistoury  up  the  canal  from  the  scrotum,  besides  giving  no  cer- 
tainty as  to  effecting  our  object ;  and  by  cutting  the  canal  im- 
mediately below  the  ring  (readily  done,  owing  to  the  difficulty  of 
passing  the  bistoury  through  the  tight  ring),  the  bowel,  on  pressure, 
readily  disappears,  but  the  patient  dies.  The  post  mortem  shows 
us  the  bowel  protruding  through  the  ring,  and  forced  through  the 
slit  in  the  canal,  outside  the  peritoneal  wall,  and  lying  between  it 
and  the  internal  abdominal  muscle.  To  prevent  such  a  grave  issue, 
a  flat  hook  on  the  point  of  the  guard  of  the  bistoury,  projecting  up 
so  as  to  protect  the  point  of  the  blade,  is  necessary ;  this  hook 
being  passed  through  the  ring  into  the  abdomen  prevents  the 
ring  from  slipping  off  the  end,  and  also  protects  the  bowels  in 
the  abdomen  from  injury,  and  greatly  facilitates  the  success  of 


'618  HERNIiE,  ETC. 

the  operation.  The  reduction  of  chronic  hernia  has  been  already 
described,  and  the  prevention  of  its  recurrence  suggests  itself. 
Castration  by  the  covered  operation  is  often  most  effectual; 
but  if  the  internal  ring  and  canal  are  large,  the  canal  may  burst 
above  the  clam,  and  the  intestines  consequently  escape  volu- 
minously. To  meet  this  difficulty  successfully,  pass  a  seton 
needle,  six  or  eight  inches  long,  through  the  skin  posterior  to  the 
canal,  and  high  up  close  to  the  ring  ;  carry  it  under  the  canal,  in 
contact  with  the  external  abdominal  muscle,  and  bring  the  point 
out  again  through  the  skin  in  front  of  the  canal;  twist  tape 
in  the  form  of  a  figure  8  over  the  two  ends  of  the  needle, 
moderately  tight,  thus  applying  acupressure  to  the  canal  close 
to  its  superior  orifice,  so  that,  hernia  even  of  the  smallest  portion 
of  the  bowels  is  impossible ;  then  castrate  by  the  covered  opera- 
tion ;  remove  the  needle  on  the  second  or  third  day  (to  avoid 
sloughing),  and  adhesive  inflammation  completes  the  cure. 

Complications  occur  from  previous  injury  leaving  the  testicle 
adherent  to  the  scrotum,  large  hydroceles,  hypertrophy  of  scrotal 
walls,  &c. ;  a  severe  blow  on  the  scrotum,  injuring  the  testicle, 
as  from  a  kick,  or  when  struck  by  the  butt  of  a  lance  or  sword 
scabbard.  The  symptoms  of  suffering  are  scarcely  distinguish- 
able from  hernia,  examination  of  the  ring  per  rectum  being 
necessary  to  a  correct  diagnosis. 

"  In  the  Recueil  for  this  year  (1875),  M.  Barry,  of  La  Ferte- 
Milon,  describes  his  method  of  operating  for  strangulated  in- 
guinal hernia.  After  stating  that  the  reduction  of  this  hernia 
is  one  of  the  most  serious  operations  the  veterinary  surgeon  has 
to  perform,  and  acknowledging  that  he  had  been  very  unsuc- 
cessful with  the  recognised  modes  of  procedure ;  he  asserts  that 
the  one  to  which  he  is  now  about  to  refer  is  that  which  has 
constantly  yielded  favourable  results,  and  is  as  easy  as  it  is 
simple. 

"The  following  is  the  procedure: — After  having  placed  in 
readiness  a  quantity  of  pure  oil,  a  convex  bistoury,  a  suture 
needle,  and  a  piece  of  strong  twine  one  to  two  yards  in  length 
disposed  as  a  large  bleeding  cord,  the  patient  is  thrown  and 
fixed  on  its  back  as  for  castration ;  and  the  envelopes  of  the 
testicle  are  carefully  mcised,  so  as  to  lay  bare  the  hernial  sac. 
When  the  knuckle  of  intestine  has  been  exposed  it  is  dressed 
with  the  oil  all  over,  and  even  gently  withdrawn  a  little  in 


OPERATION  FOR  HERNIA  IN  STALLIONS.  619 

Older  tliat  the  inflamed  part  may  likewise  be  oiled.  Tlien  the 
testicular  envelopes  are  formed  into  a  kind  of  funnel,  into  wliich 
a  quantity  of  the  oil  is  poured,  with  the  object  of  more  thoroughly 
lubricating  the  intestine,  as  well  as  the  spermatic  cord  and  in- 
guinal ring  (into  which  the  index  finger  is  introduced),  and 
ensure  the  contact  of  the  oil  with  every  part  of  the  strangulation. 
This  done,  one  hand  inserted  in  the  rectum  attempts  to  reduce 
the  hernia  by  gentle  internal  traction,  while  the  other  assists  the 
reduction  of  the  loop  by  taxis,  in  moving  the  intestine  from  side 
to  side  and  up  and  down,  and  in  doing  this  to  allow  the  oil  to 
penetrate  the  canal  the  viscus  has  to  traverse ;  this  movement 
powerfully  assists  in  the  accomplishment  of  the  operation. 

"  The  oil  has  a  triple  advantage : — 1.  It  prevents  the  irritating 
action  of  the  external  air ;  2.  It  greatly  facilitates  the  gliding 
of  the  intestine,  v/hich  has  become  dry  from  the  inflamma- 
tion; 3.  It  soothes  the  latter  to  a  certain  extent.  There  is 
nothing  to  be  apprehended  from  the  ingress  of  a  little  into  the 
abdomen. 

"  If,  notwithstanding  what  has  been  recommended,  the  hernia 
resists  attempts  at  reduction,  this  resistance  can  be  overcome  in 
combining  the  action  of  the  oil  with  puncture  of  the  intestine, 
which  was  resorted  to  in  human  medicine  a  few  years  ago. 

"  Barry  mentions  a  case  which  fully  illustrates  his  mode  of 
reduction  of  inguinal  hernia,  and  which  he  was  called  upon  to 
attend.  The  animal  was  lying  on  the  right  side,  the  hernia  was 
on  the  left.  The  disordered  movements  which  it  had  exhibited 
were  now  succeeded  by  a  suspicious  calmness,  cold  perspiration, 
small  thready  pulse,  torpor,  and  other  indications  which  betrayed 
the  approach  of  death.  Obtaining  the  consent  of  the  owner  to 
operate,  he  had  the  horse  put  in  position,  and  on  incising  the 
tunics  of  the  testicle  he  found  the  duplicature  of  intestine  of  a 
deep-red  colour,  and  even  livid  in  three  patches — always  a  very 
grave  feature.  The  loop  was  well  oiled  by  the  finger,  and  some 
oil  was  poured  into  the  cavity  in  the  manner  above  described ; 
all  the  parts  were  thoroughly  lubricated,  and  the  index  finger 
was  introduced  around  the  walls  of  the  inguinal  canal,  which 
permitted  the  oil  to  descend  more  readily,  and  assisted  in  bring- 
ing the  strangulated  intestine  a  little  farther  out.  This  organ  was 
greatly  distended  and  very  voluminous,  and  puncture  suggested 
itself ;  this  was  done  by  means  of  a  suture  needle  in  three  places 


620  HERNIiE,  ETC. 

for  two-thirds  of  its  length ;  at  the  third  puncture  a  slight  noise 
was  heard,  and  little  air-bubbles  appeared  around  the  opening. 
Barry's  right  hand  in  the  rectum,  in  concert  with  the  left,  which 
moved  the  flexure  about  two  or  three  times,  then  promptly 
reduced  the  hernia. 

Castration  was  afterwards  performed  by  ligature,  which  Barry 
prefers  to  the  clams ;  these  irritating  the  wound  by  the  great 
pressure  they  exercise  on  the  tissues  already  inflamed.  In  the 
covered,  as  well  as  in  the  uncovered  operation,  the  author  has 
always  been  successful  with  the  ligature.  The  horse  was  in  a 
short  time  afterwards  at  work. 

"Barry  asserts,  in  commenting  on  this  procedure,  that  the 
abdominal  organs  are  not  always  so  extremely  sensitive  to 
contact  with  the  air  as  is  generally  believed ;  and  he  incidentally 
alludes,  in  support  of  this  statement,  to  the  case  of  a  foal  which 
he  castrated,  and  which  the  following  morning  had  the  omentum 
hanging  as  low  as  its  hocks — hernia  of  the  peritoneum.  This 
extruded  membrane  was  red  and  very  inflamed,  and  Barry  was 
rather  puzzled  what  to  do ;  however,  he  had  the  foal  thrown ; 
with  the  right  hand  in  the  rectum"  he  seized  the  omentum,  while 
with  the  left  he  pulled  it  out  until  the  white  non-irritated 
peritoneum  appeared;  then  with  his  two  hands  pulling  in 
opposite  directions  to  stretch  it,  he  caused  the  owner  to  amputate 
the  inflamed  parts  with  a  convex  bistoury ;  this  done,  internal 
traction  completed  the  business. 

"The  animal  recovered  without  manifesting  the  slightest 
derangement." — (FLEmNG  in  Veterinarian,  March  1875.) 

SCROTAL  HERNIA  IN  PIGS. 

Scrotal  hernia  is  very  common  in  young  pigs,  and  such  should 
be  castrated  by  the  covered  operation.  The  general  practice 
amongst  pig-gelders  is  to  castrate  in  the  ordinary  way,  and  stitch 
up  the  divided  scrotum ;  sometimes  they  include  the  intestine 
in  the  suture,  and  cause  the  death  of  the  animal.  I  have  cut 
pigs  with  hernia  by  merely  enclosing  the  scrotum  in  a  loop  of 
twine,  first  returning  the  intestine,  and  allowing  the  parts  to  be 
removed  by  sloughing,  and  they  have  done  well.  Pigs  are, 
during  some  seasons,  peculiarly  liable  to  suffer  from  tetanus 
after  castration. 


GUT-TIE  IN  CATTLE.  621 


GUT-TIE  IN  CATTLE. 

Gut-tie  occurs  in  certain  districts  in  young  oxen,  more  espe- 
cially in  the  counties  of  Northampton,  Buckingham,  and  Lincoln, 
and  results  from  a  peculiar  method  of  castration  by  which  the 
spermatic  cord  is  left  too  long.  It  occurs  only  in  oxen  that  have 
been  castrated  at  an  early  age,  and  generally  shows  itself  when 
the  animal  is  about  two  or  three  years  old. 

The  spermatic  cord,  when  divided,  recedes  into  the  abdomen, 
but  adheres  partly  to  the  portion  of  intestine  in  immediate 
contact  with  it ;  or,  according  to  Mr.  Armatage  and  other  writers, 
the  spermatic  cord  becomes  fixed  by  adhesions  to  the  abdominal 
ring,  and  is  sometimes  separated  some  distance  from  the  pelvic 
bones,  but  united  to  them  by  a  layer  of  peritoneum.  In  conse- 
quence of  pressure  against  this  membrance,  rupture  takes  place, 
and  a  small  knuckle  of  intestine  passes  through,  and  shortly 
becomes  strangulated.  Sometimes  the  peritoneum  passes  before 
the  intestine,  forming  a  pouch  or  sac.  This  lesion  occurs  in  oxen 
used  for  draught.  As  the  animal  grows,  the  portion  of  the  cord 
attached  to  the  intestine,  remaining  short  in  proportion  to  the 
size  of  the  growing  animal,  draws  the  adherent  gut  towards  the 
margin  of  the  pelvis  (the  course  of  the  vas  deferens) ;  the  fold 
of  peritoneum,  separating  the  pelvic  from  the  abdominal  cavity, 
is  pressed  upon  and  ruptured  by  the  gut;  the  sac  so  formed 
incarcerating  it,  and  causing  symptoms  similar  to  those  of  stran- 
gulated hernia.  It  is  found  in  the  right  side,  because  the  left 
side  is  mainly  occupied  by  the  rumen. 

The  symptoms  are  very  characteristic :  no  passage  of  faeces,  but 
a  discharge  of  blood-covered  mucus  from  the  rectum ;  continual 
and  increasing  abdominal  pain,  the  patient  constantly  crossing 
his  legs,  and  backing  himself;  he  loathes  his  food,  and  occasion- 
ally lies  down.  The  animal  may  bear  up  against  it  for  three  or 
four  days,  particularly  if  death  is  not  hastened  by  the  injudicious 
administration  of  purgatives. 

Treatment. — Some  cases  are  relieved  by  passing  the  hand 
into  the  rectum,  and  reduction  effected  by  pushing  the  impedi- 
ment upwards  and  forwards,  so  as  to  lift  the  imprisoned  fold 
through  the  opening  in  the  peritoneum.  Should  this  not  suc- 
ceed, an  incision  is  to  be  made  into  the  right  side  of  the  flank, 
and  the  intestine  liberated  by  cutting  the  rudimentary  spermatic 


622  HERNLE,  ETC. 

cord,  and  lifting  the  imprisoned  gut  from  the  sac.  The  wound 
in  the  skin  is  to  be  closed  by  suture. 

The  lesion  and  the  methods  for  its  relief  are  well  known  to 
the  veterinarians  practising  in  the  districts  where  it  is  commonly- 
met  with,  and  they  say  that  the  animal  should  not  be  cast,  but 
the  operation  performed  whilst  he  is  standing. 

Diajphragmatic  and  Mesenteric  Hernice  will  be  considered  here- 
after, and  in  conjunction  with  internal  diseases  of  the  digestive 
organs. 


CHAPTEE  XXXV. 

DISEASES  OF  THE  BLADDER,   EXTERNAL  ORGANS  OF 
URINATION,  ETC. 

DISEASES  OF  THE   BLADDER,  VAGINA,  VESICUL^   SEMINALIS,  MAMMARY 
GLAND,   ETC. — CYSTIC   CALCULI  IN   THE   HORSE,   OX,   SHEEP,    AND 

DOG LITHOTOMY LITHOTRIPSY LITHOTRITY URETHRAL  AND 

PREPUTIAL     CALCULI SABULOUS     MATTER URETHRITIS PHY- 

MOSIS — PARAPHYMOSIS — AMPUTATION  OF  THE  PENIS — VAGINITIS 
LEUCORRHOEA — MAMMITIS. 

A  CONDITION  of  the  urine  in  which  there  is  a  tendency  to  a 
deposit  of  its  solid  elements  is  not  unfrequently  witnessed  in 
the  horse,  ox,  and  sheep;  occurring  either  in  the  form  of  an 
amorphous  impalpable  powder,  sediment,  or  sabulous  deposit ;  in 
a  crystalline  form,  gravel,  or  as  a  hard  concretion,  calculus,  or 
stone. 

In  my  own  experience,  the  sabulous  deposit  is  most  frequently 
met  with  in  mares,  the  hard  calculus  in  the  stallion  and  f^^eldin^. 
The  gravelly  form  in  oxen  and  sheep,  as  incrustations  on  ■  the 
mucous  membrane  of  the  bladder  and  urethra,  giving  rise  to  sup- 
pression of  urine,  violent  irritation  of  the  bladder,  and  frequently 
causing  the  death  of  the  animal. 

In  the  human  being  it  is  found  that  the  formation  of  calcul- 
ous concretions  depends  upon  various  conditions  of  the  body,  or 
diathesis,  the  most  remarkable  of  which  are — 1st.  The  lithic  or 
uric  acid  diathesis ;  2d.  The  phosphatic  diathesis ;  and  Sd.  The 
oxalic  diathesis.  In  the  lower  animals,  the  dog  excepted,  the 
conditions  of  urine  leading  to  the  deposition  of  solids  in  the 
bladder  are  limited  to  two,  namely,  the  presence  of  the  carbonate 
of  lime,  or  of  the  ammonio-phosphate  of  magnesia. 

In  the  horse  and  ox,  the  carbonate  of  lime  calculus  is  that 
generally  found ;  in  the  sheep  and  pig,  the  ammonio-magLetiia 
phosphate ;  and  in  the  dog,  the  uric  acid  calculus. 


624 


DISEASES  OF  THE  BLADDER,  ETC. 


The  following  may  be  taken  as  an  average  analysis  of  the 

various  calculi : — 

Horse. 
Carbonate  of  lime,  .  •  •  85-03 


Carbonate  of  magnesia, 
Phosphate  of  lime, 
Organic  matter,     . 
"Water  and  loss,    , 


3-62 
5-81 
4-21 
1-33 


100-00 


In  addition  to  these  constituents,  the  oxalate  of  lime,  silicic 
acid,  and  iron  are  occasionally  found. 


Ox  {Filrstenherg), 
Carbonate  of  lime. 
Carbonate  of  magnesia,  . 
Carbonate  of  iron, 
Organic  matter,  . 
Water  and  loss,  . 
Sihcic  acid,  inconstant. 


Sheep  (Furstenherg). 
Carbonate  of  lime. 
Phosphate  of  hme, 
Ammonio-phosphate  of  magnesia, 
Uric  acid,  ,  .  . 

Organic  matter,     . 
Iron,  water,  and  loss,        .  • 


84-8 

100 

0-6 

1-6 

30 


Kenal    Calculi. 
Dog  (Lassaigne). 


Uric  acid. 
Ammonia, 
Phosphate  of  lime. 
Oxalate  of  lime,    . 


100-0 

4-45 
9-84 
76-13 
3-00 
2-53 
4-05 

100-00 


68-0 

30-8 

101 

11 

100-0 


The  foregoing  analyses  of  Flirstenberg  have  very  clearly 
sliown  that  the  calculi  of  sheep  differ  from  those  of  the  horse 
and  ox,  in  containing  the  ammonio-magnesian  phosphate.  It 
would  be  interesting — would  space  permit — to  inquire  into  this 


CYSTIC  CALCULI.  625 

question.  It  may,  however,  be  taken  for  granted  that  the  cause 
lies  in  the  quality  of  the  food.  Very  probably  the  sheep,  from 
which  the  specimens  were  obtained,  had  been  fed  on  turnips 
and  cake,  both  articles  of  food  being  rich  in  the  constituents  of 
the  ammonio-magnesia  phosphate. 

In  the  horse,  as  well  as  in  the  domestic  animals,  the  carbonate 
of  lime  is  a  constant  component  part  of  the  urine ;  and  when, 
from  some  cause,  it  is  in  excess,  it  becomes  deposited  within 
the  bladder,  either  as  a  sediment  or  calculus.  It  is  not,  however, 
necessary  that  it  be  present  in  excess ;  for  it  is  found  that  horses 
which,  from  the  nature  of  their  work,  are  compelled  to  retain 
their  urine  for  many  hours  at  a  time,  are  most  subject  to 
calculous  deposits.  For  this  reason,  hunters  are  more  commonly 
affected  than  other  horses. 

In  the  mare,  cystic  calculi  form  around  nuclei,  such  as  pieces 
of  straw,  stones,  or  even  iron.  I  have  a  specimen  in  my 
possession  removed  from  a  mare,  in  which  the  calcareous  matter 
is  laminated  around  a  piece  of  iron.  It  can  readily  be  understood 
that  any  foreign  body  accidentally  or  maliciously  introduced 
into  the  bladder  will  cause  a  precipitation  of  the  urine  salts. 

Causes. — In  addition  to  those  enumerated,  the  causes  of 
urinary  deposits  are  to  be  looked  for  in  the  nature  of  the 
animal's  food  and  water.  Some  clovers,  for  example,  cause 
the  formation  of  large  quantities  of  urine  salts  (often  seen  on 
the  floor  of  the  stables  in  the  form  of  a  reddish-yellow  sand) ; 
and  should  any  irritation  of  the  bladder  be  induced,  an  in- 
creased secretion  of  mucus  will  be  the  consequence,  and  a 
nucleus  is  thus  formed,  around  which  the  salts  may  be  de- 
posited. 

SpnjJtoms  in  the  Horse. — Some  stiffness  in  the  hind  limbs ; 
repeated  motions  of  the  tail;  a  frequent  desire  to  urinate, 
exhibited  by  the  animal  stretching  himself  out,  drawing  his 
penis,  but  with  little  or  no  result.  At  other  times  the  excretion 
of  the  urine  is  performed  with  apparent  ease  ;  but  it  will  be 
often  seen  that  the  flow  suddenly  stops,  and  the  further  attempts 
of  the  animal  to  empty  the  bladder  prove  in  vain.  He  will 
continue  stretched  out  for  a  short  time ;  he  may  then  kick  at 
his  beUy,  groan,  sigh,  and  perhaps  lie  down  in  pain.  These 
results  are  produced  by  the  calculus  being  forced  into  the  neck 
of  the  bladder,  and  mechanically  arresting  the  further  passage,  of 

2s 


626  DISEASES  OF  THE  BLADDER,  ETC. 

the  urine.  In  other  cases,  and  more  especially  in  those  where 
the  bladder  contains  much  sabulous  matter,  there  is  incontinence 
of  urine,  which,  flowing  over  the  thighs  and  legs,  excoriates  the 
skin,  and  produces  an  erythematous  condition  of  it,  causing 
the  animal  much  annoyance,  and  giving  rise  to  much  foetor. 
In  mares  thus  affected,  incontinence  is  almost  a  constant 
symptom;  and  in  the  horse  a  dribbling  of  urine  generally 
succeeds  the  more  perfect  act  of  urination. 

The  urine  is  sometimes  of  a  high  colour,  sometimes  whitish 
or  yellowish  white,  and  deposits  a  thick  sediment  when  allowed 
to  cool  in  a  vessel,  and  a  pungent  odour  of  ammonia  is  emitted 
by  some  specimens. 

Examination  of  the  Patient  for  Cystic  Calculus. — Examination 
per  rectum — "  a  mode  of  inquiry  even  known  to  Vegetius,"  says 
Mr.  Percivall,  "  is  the  veterinarian's  grand  confirming  test  of  the 
presence  of  calculus.  It  may  be  said  to  constitute  his  diagnosis, 
for  it  will  assuredly  resolve  all  his  doubts  and  apprehensions, 
and,  moreover,  can  be  easily  and  readily  practised  without  the 
risk  of  any  injury  to  the  patient." 

In  this  method  of  examination  it  is  usual  to  empty  the  rectum 
by  an  enema  of  warm  water,  and  to  choose,  as  the  most  favour- 
able time  for  examination,  that  immediately  succeeding  the  act 
of  urination,  it  being  easier  to  detect  the  stone  in  an  empty  than 
in  a  full  bladder. 

If  the  bladder  be  full  at  the  time  of  examination,  it  should  be 
emptied  either  by  pressure  brought  to  bear  upon  it  by  the  hand 
of  the  operator  through  the  walls  of  the  rectum,  or  by  the  intro- 
duction of  the  catheter. 

It  is  recommended  by  Mr.  Percivall  that,  if  the  stone  is  not 
found  by  examination  per  rectum,  the  horse  should  be  cast, 
and  the  bladder  examined  whilst  he  is  laid  upon  his  back.  It 
may  certainly  be  necessary  to  do  this,  but  in  the  few  cases 
that  I  have  seen  the  diagnosis  has  always  been  easy  without 
casting. 

Treatment. — The  calculus  having  been  detected,  it  becomes 
the  duty  of  the  veterinarian  to  remove  it ;  and  to  do  this  an 
operation  is  necessary. 

Removal  of  the  Calculus  in  the  Mare. — The  calculus  may 
be  removed  without  cutting  the  urethra,  and  the  method  is  as 
lV»Uows : — 


CYSTIC  CALCULI.  627 

The  hand  of  the  operator,  being  well  oiled,  is  to  be  introduced 
into  the  vagina,  on  the  floor  of  which,  at  a  distance  of  four 
inches  from  the  external  opening,  the  meatus  urinarius  may 
easily  be  felt.  The  operator,  after  carefully  lifting  up  the  fold 
of  mucous  membrane,  which  here  acts  as  a  valve,  is  to  introduce 
the  fore-finger  into  the  urethra;  retaining  the  finger  in  the 
urethra,  he  must  pass  the  smaller  spoon-bill  forceps  with  the 
other  hand.  It  is  necessary  that  the  passage  of  the  forceps  bo 
guided  by  the  finger  which  is  already  in  the  urethra,  as  it  is  almost 
an  impossibility  to  pass  it  beyond  the  valvular  fold  without  this. 
When  the  forceps  is  fairly  in  the  urethra,  its  entrance  into  the 
bladder  is  to  be  effected  slowly,  its  blades  being  at  the  same  time 
slightly  opened  and  closed,  for  the  purpose  of  dilating  the  passage. 

The  forceps  having  reached  its  destination,  the  operator  is  to 
introduce  his  right  hand  along  the  vaginal  canal,  or  if  he  cannot 
get  it  sufficiently  forward,  into  the  rectum,  and  guide  the  stone 
into  the  blades. 

Firm  hold  of  the  stone  having  been  thus  obtained,  the  forceps 
is  to  be  withdrawn  with  a  gentle  rotatory  movement ;  but 
should  its  blades  be  too  small  to  grasp  the  calculus,  a  larger 
pair  must  be  introduced,  or  it  may  be  necessary  to  crush  the 
stone  before  its  removal  can  be  effected.  The  urethra  of  the 
mare  is  much  larger  than  that  of  the  horse,  and,  by  patience  and 
care,  it  can  be  dilated  sufficiently  to  allow  the  passage  of  a  very 
large  calculus. 


LITHOTOMY  IN  THE  HORSE  OR  GELDING. 

Cast  the  animal  upon  the  off  side ;  and  when  anaesthesia 
is  fully  induced  by  chloroform,  an  assistant  is  to  draw  out 
the  penis  and  introduce  the  male  catheter.  The  operator, 
having  placed  his  right  hand  in  the  rectum,  is  to  direct  the 
catheter  into  the  bladder,  as  it  is  apt  to  enter  the  ejaculatory 
ducts,  and  mislead  him  during  the  rest  of  the  operation.  The 
liability  of  the  catheter  to  enter  one  of  the  ejaculatory  ducts 
rather  than  the  bladder  is  a  matter  that  seems  to  have  escaped 
attention ;  but  it  is  liable  to  occur,  especially  in  aged  animals : 
the  operator  must  therefore  feel  that  the  instrument  passes  along 
the  median  line  into  the  bladder. 

The   catheters  made  by  the  instrument  makers  answer  the 


628  DISEASES  OF  THE  BLADDEK,  ETC. 

purpose  very  well ;  they  should,  however,  be  provided  with  a 
whalebone  stillet,  the  wire  ones  usually  provided  being  apt  to 
bend  upon  themselves,  and  remain  in  the  bent  position  when 
the  point  of  the  catheter  reaches  the  ischiatic  arch.  When  the 
instrument  has  reached  the  symphysis  pubis,  the  stillet  must  be 
withdrawn,  in  order  to  allow  the  catheter  to  pass  easily  along 
the  pelvic  floor. 

The  catheter  having  reached  its  destination,  an  incision  is  to 
be  made  upon  it,  at  the  perinseum,  so  as  to  freely  expose  the 
interior  of  the  urethra,  and  to  bring  the  catheter  fairly  and 
clearly  into  view.  The  catheter  being  withdrawn,  the  smaller 
forceps  is  to  be  introduced  into  the  urethra,  and  by  a  gliding 
motion  pushed  into  the  bladder.  Some  little  difficulty  is 
generally  experienced  in  doing  this,  from  the  fact  that  the 
sphincter  vesicce  contracts  pretty  firmly  upon  the  instrument ; 
the  operator  must  therefore  exercise  a  little  patience,  or  the 
parts  may  be  torn  by  a  forcible  introduction. 

Many  writers  describe  lithotomy  as  a  very  complicated  opera- 
tion, and  that  it  must  be  performed  by  various  cuttings  with 
long-bladed  bistouries,  guided  by  "  directors,"  &c.,  and  Professor 
Dick  used  to  say  that  it  was  necessary  to  take  up  the  pudic 
artery ;  but  none  of  these  are  requisite,  one  free  incision,  suffi- 
ciently large  to  admit  the  forceps,  is  all  that  is  required.  I 
have  operated  in  this  manner,  both  for  the  stone,  and  experi- 
mentally, before  my  class  repeatedly,  and  always  successfully. . 
It  is  advisable  that  the  forceps  be  warmed  and  dipped  in  oil 
before  it  is  introduced,  as  the  sensation  of  cold  causes  the 
sphincter  of  the  bladder  to  contract  with  some  force,  and  it^ 
introduction  to  be  a  matter  of  difficulty. 

The  operation  of  cutting  for  the  stone  is  called  lithotomy; 
that  of  crushing  the  stone  without  cutting,  lithotripsy  ;  and  that 
of  boring  or  rubbing  the  calculus,  in  order  to  reduce  it  to  powder, 
lithotrity.  These  two  latter  methods  are  inapplicable,  except  in 
the  mare ;  but  it  may  be  necessary  to  crush  the  stone  in  the 
horss  before  removal,  and,  in  such  a  case,  the  operation  would  be 
a  combination  of  lithotomy  and  lithotripsy. 

Provided  the  stone  cannot  be  grasped  wliilst  the  horse  is  upon 
his  side,  he  must  be  placed  upon  his  back,  care  being  always 
taken  that  the  hand  in  the  rectum  shall  guide  the  stone  into  the 
forceps. 


LITHOTOMY  IN  THE  HORSE  OR  GELDIJJG.  629 

The  after  treatment  of  the  case  consists  in  washing  out  the 
bladder  with  tepid  water ;  the  approximation  of  the  lips  of  the 
wound  by  sutures  ;  allaying  irritation  and  pain  by  opium  ;  and 
keeping  the  bowels  regular  by  gentle  aperients. 

In  some  experiments  which  I  conducted,  the  skin  was  drawn, 
to  one  side  before  the  incision  was  made  ;  this  caused  the  wound 
in  the  urethra  to  be  subcutaneous.  I  found,  however,  that 
although  the  urine  did  not  escape  through  it  very  profusely, 
there  was  a  collection  of  it  in  the  areolar  tissue,  which  led  to  a 
high  degree  of  inflammation  and  purulent  infiltration. 


LITHOTOMY  IN  THE  OX. 

The  introduction  of  the  catheter  is  rendered  impossible  in  this 
animal,  owing  to  the  curve  of  the  penis ;  and  hence  the  removal 
of  a  calculus  can  only  be  accomplished  by  cutting  on  to  the 
urethra.  Calculi  are,  however,  most  commonly  found  in  the 
urethra  in  these  animals,  and  by  following  its  course  externally 
it  will  be  found  distended  and  fluctuating  until  the  obstruction 
is  reached.  This  has  to  be  cut  upon  and  removed,  and,  as 
Professor  Dick  used  to  say,  "  speedy  relief  will  be  given."  In 
some  cases  in  the  ox  it  has  been  recommended  to  tap  the 
bladder  through  the  rectum ;  the  necessity  of  this  is  very 
doubtful,  as  it  can  always  be  reached  by  a  perineal  incision 
and  the  introduction  of  a  catheter  through  the  opening  thus 
made. 


URETHRAL   CALCULI 

Occur  in  sheep  as  well  as  in  oxen,  and  give  rise  to  symptoms  of 
great  distress.  The  affected  animals  repeatedly  attempt  to 
urinate,  and  like  the  ox,  pant,  grunt,  are  restless,  alternately 
lie  down  and  rise,  become  listless,  and  if  not  relieved,  die  with 
symptoms  of  abdominal  pains  and  irritative  fever.  They  should 
be  examined,  and  the  calculi  removed,  as  in  the  ox. 


PREPUTIAL  CALCULI. 

When  these  calculi  attain  a  sufficient  size  to  produce  stran- 
gury, they  cause  inconvenience.    They  are  sometimes  true  calculi 


630  DISEASES  OF  TEE  BLADDER,  ETC. 

in  the  horse,  but  more  commonly  are  composed  of  dirt  mixed 
with  the  secretion  of  the  sebaceous  follicles  of  the  prepuce  and 
sheath.  In  order  to  prevent  inconvenience  from  these  con- 
cretions, the  sheath  must  be  examined  and  washed.  Horses 
with  large  pendulous  sheaths  are  very  subject  to  them. 

In  the  ox  and  sheep,  when  fed  on  turnips  or  other  phosphatic 
food,  long  stalactite-like  deposits  of  the  phosphates  form  around 
the  preputial  opening,  causing  obstruction  to  the  emission  of 
urine  and  much  inconvenience ;  they,  and  the  hair  or  wool 
they  are  attached  to,  are  to  be  cut  off. 

REMOVAL  OF  SABULOUS  MATTER. 

In  the  case  of  a  gelding,  an  operation  as  for  lithotomy  has 
to  be  performed,  and  the  contents  of  the  bladder  scooped  o^it  by 
the  forceps  or  a  spoon,  and  the  bladder  thoroughly  washed  by 
a  stream  of  water  forced  in  by  "  Eeade's  pump."  In  the  mare 
this  can  be  effected  without  cutting. 

Animals  that  have  much  sediment  in  the  urine  should  be 
allowed  small  doses  of  hydrochloric  acid  in  their  water  every 
now  and  then ;  the  acid  passing  out  of  the  body  through  the 
kidneys  and  bladder  will  dissolve  the  earthy  carbonates,  which, 
thus  rendered  soluble,  are  ejected  with  the  fluid  constituents  of 
the  urine. 

DISEASES  OF  THE  EXTERNAL  ORGANS  OF  GENERATION. 

It  may  be  accepted  that  the  lower  animals  are  free  from  specific 
diseases  of  the  generative  organs,  and  that  those  affections  charac- 
terised by  a  discharge  are  due  to  simple  inflammation  of  the 
mucous  membrane,  catarrh,  debility,  or  tumours. 

URETHRITIS — ^INFLAMMATION  OF  THE  URETHRA. 

This  may  occur  in  the  gelding  as  well  as  in  the  entire  horse ; 
in  the  former  from  a  general  catarrhal  condition  of  the  mucous 
membrane,  and  from  the  irritation  of  some  medicines,  such  as 
cantharides  or  croton ;  in  the  latter — in  addition  to  the  above 
causes — from  copulation  too  frequently  performed,  the  general 
system  being  at  the  same  time  rendered  susceptible  of  inflam- 
mation by  stimulating  food  or  medicines.     Hutrel  D'Arboval 


INFLAMMATION  OF  THE  miETHKA.  C31 

says  that  a  stallion  may  be  thus  affected  from  covering  a  mare 
with  a  small  vagina.  In  bulls,  this  affection  is  not  at  all  uncom- 
mon, but  I  am  of  opinion  that  it  is  more  a  result  of  injury  due 
to  rashness  in  the  act  than  to  any  other  cause. 

Symptoms. — Frequent  desire  to  urinate,  the  act  performed 
with  difficulty ;  frequent  erection  of  the  penis ;  and  a  discharge 
from  the  urethra.  The  genitals  may  afterwards  swell,  and  ulcer- 
ations may  form  upon  the  prepuce. 

Treatment. — The  parts  to  be  bathed  with  warm  water,  dressed 
with  mild  astringents,  which  may  be  injected  into  the  urethra, 
and  the  animal  to  have  mild  aperients  and  the  bicarbonate  of 
soda.  If  the  case  be  chronic,  the  animal  may  have  to  be  cast, 
the  parts  examined,  and  all  ulcerated  surfaces  dressed  with  the 
nitrate  of  silver. 

Hutrel  D'Arboval  describes  a  disease  in  the  horse  simulating 
syphilis,  characterised  by  inflammatory  irritation  of  the  glans 
penis,  extending  to  the  sheath,  presenting  a  tense,  shining  appear- 
ance, and  giving  rise  to  phymosis  or  paraphymosis. 

I  have  seen  a  condition  similar  to  this  originating  in  cancer 
of  the  penis,  as  well  as  in  those  causes  described  by  D'Arboval 
in  his  dictionary. 

Causes. — According  to  D'Arboval,  this  form  of  irritation  is 
found  in  horses  whose  genitals  are  habitually  dirty ;  or  arising 
from  accidents,  or  the  introduction  of  foreign  substances  into 
the  sheath. 

Treatment. — Emollient  fomentations  to  the  parts ;  cleanli- 
ness ;  if  abscesses  form,  they  must  be  laid  open,  dressed  with 
w^eak  carbolic  acid  lotions,  and  the  general  system  modified  by 
mild  cathartics,  bicarbonate  of  soda,  and  demulcent  drinks, 
such  as  linseed  tea.  In  the  more  ^^hronic  cases,  it  may  be 
necessary  to  apply  the  nitrate  of  silver,  or  even  to  amputate 
the  penis. 

The  Vesicul^  Seminalts  are  but  very  rarely  the  seat  of  disease; 
but  I  have  met  with  instances  in  young  bulls,  where  they  have 
been  distended  by  an  accumulation  of  epithelium,  imperfect 
semen,  and  debris.  The  symptoms  are,  pain  and  straining  in 
defsecation,  and  difficult  micturition.  On  exploring  the  rectum 
to  discover  the  cause  of  these  symptoms,  a  fluctuating  tumour 
w^ill  be  discovered  upon  one,  perhaps  both,  sides  of  the  pelvis, 
"oressing  upon  the  urethra  and  neck  of  the  bladder. 


C32  DISEASES  OF  THE  BLADDER,  ETC. 

The  accumulation  within  the  vesicle  seems  to  be  due  to  some 
cause  of  obstruction  in  the  ejaculatory  duct,  for  by  firm  yet  gentle 
pressure  the  contents  can  be  forced  out,  and  the  tumour  reduced  in 
a  few  minutes,  the  contents  being  discharged  through  the  urethra. 
If  the  symptoms  recur,  it  will  be  necessary  to  repeat  the  ex- 
amination, and  again  press  out  the  accumulation. 


PHYMOSIS, 

"  A  morbid  condition  of  the  prepuce  or  sheath,  which,  from  con- 
traction of  the  orifice,  prevents  the  drawing  or  exit  of  the  penis." 
— (Percivall.) 

Phymosis  is  the  result  of  inflammation  or  engorgement  of  the 
sheath  round  about  the  orifice,  or  of  enlargement  of  the  glans 
penis,  or  of  co-existence  of  these  states.  Blows,  kicks,  conta- 
sions,  wounds,  abscesses  within  the  sheath,  the  presence  of  warts 
or  excrescences  of  any  kind,  polypi  even,  may  all  be  set  down 
as  occasional  causes.  In  geldings  the  penis  becomes  diminished 
in  volume  and  length,  so  much  so  in  some  horses  as  not  to 
appear  protruded  in  the  act  of  urination;  in  which  case  the 
sebaceous  secretion  furnished  by  the  interior  of  the  prepuce 
accumulates  within  the  folds  of  the  integument,  and  acquires, 
by  detention,  irritating  properties,  which  cause  the  glans  penis 
to  inflame  and  swell  to  that  degree  that  the  animal  can  no 
longer  pass  his  urine.  In  addition  to  these  causes  phymosis  is 
occasionally  seen  when  the  sheath  is  much  swollen  from  oedema, 
produced  by  want  of  exercise,  disease,  the  stings  of  insects,  or 
castration. 

The  treatment  must  depend  upon  the  cause.  If  that  be  inflam- 
matory, antiphlogistics,  fomentations,  and  perhaps  scarifications ; 
if  cedematous,  scarifications,  frictions  wdth  the  hand,  exercise, 
diuretics,  or  purgatives,  as  the  case  may  be;  and  when  asso- 
ciated with  debilitating  diseases,  tonics  and  good  food.  Cold 
fomentations  are  generally  of  great  service. 

PAEAPHYMOSIS. 

The  penis  is  protruded  in  paraphymosis,  and  cannot  be  with- 
drawn within  the  sheath.  It  may  arise  from  a  weakened  con- 
dition of    the  penis,  sometimes   associated   with   debiKtating 


PARAPHYMOSIS.  *  G33 

diseases,  or  a  paralysis  sui  generis,  or  from  swelling  of  the  glans 
penis,  with  protrusion  and  enlargement  of  it,  arising  from  an 
accident  or  castration ;  the  sheath  forming  a  tight  constriction 
round  it,  and  preventing  its  retraction.  "The  penis  paraphy- 
mosed  "  (says  D'Arboval)  "  appears  protruded  out  of  its  sheath 
to  the  extent  of  half  a  foot,  swollen  to  the  size  perhaps  of  a 
man's  thigh,  evidently  in  consequence  of  effusion  into  the  cel- 
lular tissue  of  its  envelopes,  and  is  curved  in  the  form  of  an  arc, 
and  knotted  from  partial  circular  contractions,  which,  when 
excessive,  are  productive  of  coldness  of  the  organ.  Its  ex- 
tremity, the  part  most  tumefied,  turns  of  a  red  browai ;  violent 
inflammation  accompanies  all  this,  and  the  consequent  pain  is 
extreme.  For  all  there  is  so  much  swelling,  however,  in  general 
the  urine  gets  a  passage,  though,  should  the  inflammation  run 
very  high,  and  spread  to  the  body  of  the  penis,  gangrene  may  bo 
the  result." 

In  this  country  paraphymosis  arises  from  oedema  or  inflam- 
mation of  an  already  weakened  or  paralysed  penis,  and  is 
usually  met  with  in  old  geldings,  or  in  young  ones  when  suffering 
from  debility  or  disease.  In  the  one  case  the  paralysis  is  usually 
a  permanent  condition ;  whilst  in  the  other  it  is  temporary,  de- 
pending upon  muscular  debility,  and  usually  disappearing  when 
the  general  strength  of  the  animal  is  restored.  Instances  are 
recorded  where  the  pendulous  penis  has  been  returned  into  its 
sheath,  and  maintained  there  by  firm  stitches,  and  the  animal 
sold  as  a  sound  one,  the  trick  not  being  discovered  until  the  new 
owner  has  had  possession  for  a  few  hours,  or  even  a  day  or  two, 
when,  the  sutures  giving  way,  the  penis  has  returned  to  its  former 
pendulous  position. 

Treatment. — For  paraphymosis  resulting  from  paralysis,  am- 
putation is  the  only  remedy ;  but  for  the  same  condition,  when 
arising  from  accidental  causes,  or  from  a  state  of  general  debility 
brought  about  by  disease  or  other  weakening  influences,  the 
symptoms  of  urgency  only,  namely,  the  pain,  swelling,  febrile 
disturbance,  and  other  associated  conditions,  demand  the  practi- 
tioner's attention.  In  many  instances  the  swelling  will  depend 
upon  an  oedematous  condition  of  the  parts  generally ;  the  sheath 
will  be  swollen,  forming  a  constricted  neck  around  the  pendulous 
penis,  arresting  its  circulation  to  some  extent,  and  finally  pro- 
ducing a  tense   inflammatory   swelling.     In  cases   of  general 


684  DISEASES  OF  THE  BLADDER,  ETC. 

debility,  or  of  any  disease  accompanied  by  pendulosity  of  the 
penis,  and  oedema  of  the  sbeath,  legs,  and  under  parts  of  the 
abdomen,  the  local  treatment  must  be  directed  to  prevent  partial 
strangulation  of  the  penis,  by  puncturing  the  sheath,  fomenting 
with  cold  water,  and  applying  friction  to  the  part ;  the  general 
system  being  at  the  same  time  treated  by  diuretics  to  stimulate 
and  promote  the  absorption  of  the  effusion ;  tonics,  and  more 
especially  a  combination  of  nux  vomica  and  iron,  to  excite  the 
appetite,  to  promote  the  assimilation  of  the  food,  and  act  as  a 
nervine  tonic  upon  the  structures  of  the  weakened  muscles  of 
tlie  system  generally,  and  upon  those  of  the  penis  more  particu- 
larly ;  and,  in  addition,  the  horse  must  have  good  food,  regular 
exercise,  and  careful  grooming. 

Should  actual  inflammation  of  the  penis  exist,  with  great 
engorgement  of  its  vessels,  and  a  tense,  shining  swelling  of  its 
whole  substance,  it  may  be  necessary  to  suspend  it ;  at  the  same 
time  making  use  of  the  suspensory  bandages  for  the  application 
of  soft  poultices,  as  boiled  turnips,  to  as  much  as  can  be  covered 
of  the  inflamed  structures. 

For  the  rapid  reduction  of  the  swelling — and  this  is  a  point 
of  much  importance —  cold  applications  are  preferable  to  w^arm ; 
cold  water,  cold  astringent  lotions,  and  cold  poultices.  In  addi- 
tion to  scarifications,  in  all  cases  that  admit  it,  exercise  is  useful, 
by  removing  venous  engorgement  and  exciting  the  absorption  of 
fluids.  In  cases  resulting  from  an  accident  or  an  operation,  it 
may  be  necessary  to  give  a  purgative,  or,  perhaps,  anodynes  and 
sedatives ;  but  in  those  arising  from  debility,  except,  indeed,  the 
local  symptoms  are  very  severe,  depletion  of  any  kind  is  to  be 
avoided. 

Mr  Broad  of  Bath  recommended  the  following  treatment : — 

Put  the  penis  into  a  tight  elastic  stocking  by  squeezing  it 
with  the  hands,  and  as  it  reduces,  lessen  the  size  of  the  stocking, 
and  suspend  the  penis  as  much  as  possible.  If  there  be  much 
effusion  into  the  surrounding  tissues,  apply  a  wide  canvas  band, 
with  long  straps  and  buckles,  round  the  body,  so  as  to  support 
and  cause  pressure  to  the  swollen  tissues.  A  few  hours'  com- 
pression from  the  stocking  wiU  often  reduce  it  sufiiciently  to 
enable  the  horse  to  retract  it. 


AMPUTATION  OF  THE  PENIS.  635 


AMPUTATION  OF  THE  PENIS. 


Instances  occur  when  it  becomes  necessary  to  remove  the 
penis  by  amputation.  *' A  state  of  disease"  (says  Mr.  Percivall), 
"  either  of  the  penis  or  of  its  preputial  covering,  such  as  has 
resisted,  or  seems  likely  to  resist,  all  treatment ;  or,  indeed,  such 
as  would  probably  occupy  any  unreasonable  length  of  time  to 
cure,  might,  perhaps,  warrant  a  recourse  to  amputation." 

I  have  performed  this  operation  upon  four  horses,  and  in  two 
of  them  with  permanent  success ;  in  one  with  temporary  success, 
whilst  one  case  terminated  fatally  in  a  few  hours  after  the  opera- 
tion, the  animal  being  very  aged  and  feeble.  Three  of  the  animals 
were  geldings,  and  one  a  stallion.  Two  of  them  had  cancer  of  the 
penis  ;  the  others  were  suffering  from  paralysis  and  ulceration  of 
that  organ.  The  operation  was  performed  as  follows : — The  animal 
having  been  cast  and  chloroform  administered,  a  catheter  was  in- 
troduced into  the  urethra,  and  retained  there  by  the  passage  of  a 
ligature  round  the  penis,  an  inch  or  two  above  the  seat  of  the 
intended  incision.  The  ends  of  the  ligature  were  left  long — the 
ligature  itself  being  of  strong  twine — so  that  the  penis  could  be 
fully  controlled  during  the  operation.  When  a  large  portion  of 
the  penis  had  to  be  removed,  the  ligature  was  passed  through 
the  healthy  portion  of  the  penis  with  a  strong  packing-needle,  in 
order  to  prevent  withdrawal  into  the  sheath  before  the  arterial 
branches  were  secured.  Everything  being  now  fully  at  com- 
mand, the  diseased  structures  were  removed  by  a  bold  circular 
incision,  the  arteries  searched  for,  and  secured  by  ligature.  But 
little  haemorrhage  occurred  in  any  of  the  cases  operated  upon 
until  some  hours  had  elapsed  ;  but  at  this  time  some  discharge 
of  blood  took  place,  and  continued  occasionally  for  a  few  days, 
and  arose  from  the  corpus  cavernosum  becoming  filled  with  blood, 
in  consequence  of  slight  erections  of  the  penis,  resulting  from 
the  irritation  of  the  parts,  more  especially  during  the  act  of 
urination.  In  one  case — that  of  the  stallion — these  erections 
were  frequent,  and  the  haemorrhage — which  was  of  a  dark 
venous  character — alarming,  but  it  could  always  be  controlled  by 
the  appUcation  of  cold  water.  In  order  to  prevent  this  venous 
haemorrhage,  I — in  one  case — allowed  the  ligature  and  catheter 
to  remain  in  situ  for  some  time,  fastening  the  catheter  to  the 
belly  by  means  of  a  cord  tied  round  it,  and  carried  over  the 


636  DISEASES  OF  THE  BLADDER,  ETC. 

animars  back.  I  cannot  say  that  it  did  mucli  good,  as  it  caused 
some  uneasiness,  and  had  to  be  withdrawn. 

In  the  case  which  ended  fatally  the  penis  was  so  swollen 
and  indurated  that  it  was  impossible  to  draw  it  from  the  sheath, 
and  a  long  incision  had  to  be  made  through  the  integuments, 
immediately  below  the  ischial  arch,  and  the  parts  amputated 
through  the  opening  thus  made. 

In  some  cases,  the  flow  of  urine  becomes  arrested  after  the 
parts  have  healed  up,  the  process  of  cicatrisation  corrugating  the 
urethral  opening ;  and  in  such  it  has  been  found  necessary  to 
divide  the  condensed  cicatrix. 

This  condition  only  arose  in  one  of  my  patients,  and  he, 
being  old,  -was  not  submitted  to  this  procedure.  M.  Barthelmy, 
in  a  paper  upon  this  subject,  read  before  the  Eoyal  French 
Academy  of  ^Medicine,  thus  concludes  : — "  1st.  That  amputation 
of  the  penis  may  be  performed  on  the  gelding  without  any 
apprehension  from  haemorrhage  ;  2d.  That  to  avoid  any 
obstruction  of  the  urethra,  a  pipe  should  be  placed  in  the  canal, 
and,  by  rings  af&xed  to  it,  sustained  therein  for  at  least  tv.o 
months." 

HYDROCELE,  OR  DROPSY  OF  THE  SCROTUM, 

Is  a  very  rare  disease  in  this  country.  Occasionally  a  gush  of 
serum  issues  from  the  scrotum  during  castration,  but  it  is  of  no 
consequence. 

DISEASES  OF  THE  VAGINA  AND  MAMMARY  GLAND. 

Vaginitis,  or  inflammation  of  the  vagina,  except  as  a  compli- 
cation of  catarrhal  influenza,  or  a  result  of  difficult  parturition, 
is  almost  an  unknown  disease.  This  arises  from  the  fact  that 
the  female  organs  of  generation  remain  in  a  state  of  inactivity 
during  the  greater  part  of  the  year,  and  is  in  accordance  with 
the  general  law  which  exempts  from  disease  those  parts  whose 
functions  are  rarely  called  into  action. 

Vaginitis,  unless  it  result  from  the  violence  employed  in 
delivering  the  mare  of  lier  young,  or  inflicted  during  the  act  of 
coition,  or  injury  otherwise  done,  is  merely  characterised  by  a 
discharge  from  the  vulva  of  a  greyish-white  mucus,  which  soon 
changes  to  a  yellowish- white  purulent-looking  material.     The 


DISEASES  OF  VAGINA  AND  MAMMARY  GLAND.  637 

discharge  of  this  material  is  inconstant ;  it  collects  in  the  fossa 
navicularis,  and  comes  away  in  gushes  at  uncertain  periods,  par- 
ticularly when  the  lips  of  the  vulva  are  opened.  The  mucous 
membrane  is  reddened  at  the  earlier  stages  of  the  disease,  but 
becomes  blanched  when  the  affection  has  existed  for  some 
time.  There  is  but  little  constitutional  disturbance.  Very  pro- 
bably the  animal  is  suffering  from  a  common  cold,  contracted 
during  the  period  of  oestrum ;  and  generally  but  little  treatment 
is  required. 

When  vaginitis  has  been  caused  by  violence  of  any  kind, 
symptoms  of  a  much  graver  character  than  the  above  manifest 
themselves.  The  mucous  membrane  becomes  highly  injected, 
at  first  dry  and  hot ;  but  a  discharge  soon  takes  place,  of  a  thin 
sanious  material,  very  acrid  in  its  nature,  irritating  all  parts 
with  which  it  may  come  in  contact,  and  increasing  the  inflam- 
mation already  existing,  causing  such  an  amount  of  straining 
as  to  threaten  inversion  of  the  uterus,  and  calling  for  the  free 
administration  of  opium.  I  have  seen  this  form  in  the  cow  and 
bitch,  as  well  as  in  the  mare.  When  succeeding  parturition, 
it  is  accompanied  by  much  systemic  disturbance,  and  may 
prove  fatal  by  extending  into  the  uterus. 

Treatment. — This  must  be  directed  to  lessen  the  local  irrita- 
tion, and  to  prevent  the  straining  which  it  excites.  This 
straining  becomes  in  some  instances  an  alarming  complication, 
and  it  may  be  so  severe  as  to  cause  inversion  of  the  uterus. 
Warm  fomentations  to  the  loins  and  perinseum  are  very  sooth- 
ing, and  assist  in  promoting  a  discharge  of  a  less  irritating  mate- 
rial from  tlie  inflamed  surface.  The  vagina  may  be  injected 
with  warm  water  containing  opium,  and  should  there  be  any 
foetor,  Condy's  fluid  or  the  hyposulphite  of  soda  can  be  added 
with  advantage.  The  constitutional  treatment  must  be  that 
calculated  to  soothe  without  debilitating ;  for  it  must  be  remem- 
bered that  the  inflammation  and  the  accompanying  fever  are  of 
a  low  type — the  inflammation  partaking  of  the  diffuse  nature  of 
erysipelas,  and  the  fever  of  the  typhoid  character.  Opium, 
belladonna,  or  hyoscyamus,  in  combination  with  the  bicarbonate 
of  soda,  are  best  calculated  to  allay  the  pain ;  and  should  the 
bowels  be  constipated,  enemas  are  to  be  employed  in  preference 
to  purgatives. 

No   active  steps  should   be  taken  at  first  to  suppress  the 


638  DISEASES  OF  THE  BLADDER,  ETC. 

discharge  by  the  injection  of  any  astringent  remedy.  The 
inflammation  must  be  first  reduced,  and  the  cessation  of  the 
discharge  will  generally  follow.  Should  the  discharge  become 
chronic,  continuing  for  a  long  time  after  the  more  urgent 
symptoms  have  passed  away,  the  disease  is  then  termed  leu- 
corrhoea,  fluor-albus,  or  the  whites,  and  must  be  combated  by 
local  astringent  injections,  and  the  administration  of  tonics, 
more  especially  the  salts  of  iron  or  copper,  combined  with  small 
doses  of  cantharides. 

Many  cases  of  vaginal  discharges  depend  on  tumours  of  a 
cancerous,  fatty,  or  epithelial  character,  or  upon  bruises  or  ulcers 
caused  by  the  wilful  introduction  of  hard  substances,  such  as 
fork-handles,  by  mischievous  boys.  In  all  cases  the  parts  are 
to  be  carefully  examined,  and  the  offending  cause  removed.  I 
remember  one  case  of  a  young  mare  being  injured  by  a  large 
stallion,  where  the  vaginitis  so  produced  was  succeeded  by  the 
formation  of  multiple  abscesses  in  various  parts  of  the  body. 
She  eventually  recovered  under  a  tonic  treatment. 

Tumours  in  the  vagina  are  but  rarely  seen  in  the  mare,  but  they 
are  not  uncommon  in  some  breeds  of  cattle  ;  they  vary  in  size 
from  a  marble  to  a  goose's  egg,  are  round  or  oval  in  form,  and 
the  mucous  membrane  covering  them  is  traversed  by  enlarged 
and  congested  veins.  These  seldom  require  to  be  interfered 
with ;  but  if  they  cause  irritation,  discharge,  pain,  or  obstruct 
the  emission  of  urine,  they  are  to  be  removed,  by  torsion  if 
pedunculated,  or  by  clam  and  cautery  if  broad  in  the  base. 

Vaginal  haemorrhoids  are  sometimes  met  with  in  bitches ; 
either  single  or  multiple,  pedunculated  or  on  broad  bases.  They 
are  prone  to  bleed,  and  cause  a  good  deal  of  irritation  and  pain, 
manifested  by  some  degree  of  straining,  difficult  micturition, 
and  general  restlessness.  The  best  method  of  removing  them  is 
with  the  cautery  or  some  strong  caustic,  as  their  bases  or  roots 
must  be  destroyed,  or  they  are  almost  sure  to  recur.  If  caused 
by  high  feeding  and  want  of  exercise,  the  patient  should  be 
purged  and  the  causes  avoided. 


MAMMITIS,  OR  INFLAMMATION  OF  THE  MAMMARY  GLAND. 

Acute  inflammation  of  the  udder  is  of  rare  occurrence  in  the 
mare,  but  is  frequently  met  with  in  the  cow.  I  have  seen  it  in 
mares  during  the  active  period  of  lactation,  also  when  the  gland 


MAMMITIS.  639 

lias  been  inactive — in  mares  with  foals  at  their  feet,  and  in 
others  which  had  never  been  pregnant.  The  exciting  causes 
may  be  general  or  local.  To  the  former  belong  irregularities  of 
diet,  a  tendency  to  the  disease  termed  lymphangitis  or  weed, 
frequent  recurrence  of  the  periods  of  oestrum ;  and  to  the  latter, 
contusions,  the  direct  application  of  cold,  and  external  injury. 
Cows  are  subject  to  it,  when  in  a  plethoric  condition  at  the  time 
of  parturition,  or  if  the  animal  be  turned  to  a  rich  pasturage, 
when  the  organ  is  in  high  activity.  The  last  cause  is  a  very 
common  one,  and  acts  by  stimulating  an  organ  in  an  already  high 
state  of  activity ;  and  it  is  an  example  of  a  healthy  congestion 
being  transformed  into  an  inflammation  by  over-stimulation. 

Inflammation  of  the  mammary  gland  is  also  very  frequently 
caused  by  a  cruel  practice  called  "hefting,"  or  "over-stocking." 
This  consists  in  the  preparation  of  the  cow  for  show  or  market, 
by  allowing  her  to  go  unmilked  until  the  mammary  gland 
becomes  fearfully  distended  with  its  secretion,  in  order  that  the 
milk  vessel  may  have  what  is  considered  a  fine  appearance. 
'Not  contented  with  allowing  the  gland  to  become  filled  until  it 
can  no  longer  contain  the  milk,  the  natural  provision  for  relief, 
namely  "  spontaneous  flow  of  milk,"  is  prevented  by  plugging 
the  teats  with  cobbler's  wax  or  gutta-percha.  ^  Some  scoundrels 
go  even  farther  than  this.  They  have  a  mould  made  to  resemble 
a  most  symmetrical  udder,  with  the  teats  in  a  perfect  position, 
which  is  fastened  below  the  udder,  the  animal  being  put  in  a 
frame  made  for  the  purpose,  and  as  the  gland  becomes  distended 
with  milk  it  is  thus  moulded  into  the  required  shape.  This  is  a 
species  of  cruelty  that  the  law  of  the  land  ought  to  suppress. 
It  is  often  followed  by  violent  inflammation,  resulting  in  the 
obliteration  of  one  or  more  quarters  of  the  gland,  or  even  by 
gangrene. 

Cows  giving  no  milk,  when  being  fattened  for  the  butcher, 
frequently  suffer  from  a  modified  form  of  mammitis,  which  re- 
tards the  process  of  fattening  very  materially.  This  is  caused 
by  the  retention  of  some  milk  in  the  gland,  where  it  becomes 
curdled,  and  acts  as  an  irritant.  There  is  a  very  cruel  but  very 
eflective  method  for  the  prevention  and  cure  of  this  in  some 

^  Latterly  a  more  artistic  method  has  been  discovered,  and  is  extensively  prac- 
tised. The  process  consists  in  covering  the  teat,  after  it  is  first  manipulated  into 
proper  shape,  by  a  solution  of  white  gutta-percha  or  collodion,  which  rapidly  dry 
and  render  the  flow  of  the  milk  impossible. 


C40  DISEASES  OF  THE  BLADDER,  ETC. 

parts  of  the  country,  namely,  excision  of  the  teat  of  the  inflamed 
quarter  of  the  gland.  This  allows  the  milk  to  escape ;  but  it 
can  be  equally  effected  by  an  incision  at  the  superior  part  of  the 
teat,  or  in  some  cases  by  frequent  frictions  with  belladonna. 

Acute  mammitis  seldom  attacks  the  whole  gland,  but  is  con- 
fined to  oiie  or  more  quarters,  and  is  expressed  by  swelling,  heat, 
pain,  and  redness  of  the  part  inflamed,  with  an  alteration  in  the 
physical  properties  of  the  milk,  which  is  curdled,  whey-like,  and 
mixed  with  blood.  There  is  generally  much  accompanying  sys- 
temic disturbance ;  rigors,  succeeded  by  increased  heat  of  skin. 
The  bowels  are  generally  disordered,  being  either  constipated  or 
unnaturally  loose. 

The  exudation  formed  in  the  substance  of  the  gland  very  fre- 
quently destroys  its  secreting  properties,  blocking  up  the  acini, 
lactiferous  ducts  and  sinuses,  and  leading  to  the  conversion  of 
the  glandular  structure  into  a  mass  of  fibrous  tissue.  This  altera- 
tion of  structure  is  followed  by  wasting  of  the  previously  swollen 
part,  which  becomes  a  hard,  almost  cartilaginous  mass,  smaller 
than  the  healthy  portions  of  the  gland,  and  constitutes  an  un- 
soundness. A  cow  with  only  three-quarters  of  the  udder  secret- 
ing milk  is  of  less  value  than  when  the  whole  is  intact.  In  some 
instances  the  secreting  properties  may  return  after  the  next 
calving,  but  in  others  this  desirable  result  is  not  obtained.  The 
other  terminations  are — (1.)  Eesolution  of  the  inflammation,  and 
restoration  of  the  lactiferous  structures  to  their  natural  condi- 
tion ;  (2.)  Suppuration,  the  gland  becoming  hard  in  parts,  which 
afterwards  suppurate  and  burst  externally,  or  the  pus  may  be 
discharged  through  the  teat ;  and  (3.)  Gangrene  of  the  inflamed 
quarter.  Tliis  result  is  apt  to  occur  in  cows  that  are  narrow 
between  the  thighs — Alderneys  and  Guernsey,  and  other  narrow 
cows — and  is  caused  by  the  pressure  of  the  thighs  upon  the 
swollen  udder ;  or  it  may  result  from  the  severity  of  the  disease 
in  cows  that  are  well  formed  in  this  respect. 

Treatment. — Eemoval  of  the  exciting  cause,  attention  to  the 
state  of  the  digestive  organs,  and  for  the  purpose  of  removing 
any  source  of  irritation  which  may  be  contained  in  them,  gentle 
cathartics  and  alkalies  are  useful.  The  accompanying  fever  is 
to  be  moderated  by  aconite  and  the  nitrate  of  potash ;  and  should 
the  cow  be  inclined  to  eat,  she  must  be  fed  upon  food  devoid  of 
much  milk-producing  constituents.  This  is  essential  to  success, 
as  it  gives  rest  to  the  inflamed  structures.    Soft  food  of  any  kind 


MAMMITIS.  641 

is  to  be  proliibited,  and  water  must  be  allowed  sparingly.  Some 
practitioners  recommend  stimulants ;  but  unless  there  be  gan- 
grene of  the  gland,  and  much  general  debility,  this  method  is 
calculated  to  do  harm. 

The  local  treatment  is  of  great  importance.  In  the  first  place, 
the  milk  ought  to  be  frequently  drawn ;  and  if  this  cannot  be 
done  with  the  hand,  the  teat-syphon  must  be  used.  The  with- 
(h'awal  of  the  milk,  which  is  curdled  and  often  mixed  with 
blood,  and  fomentations  with  warm  water,  are  generally  suffi- 
cient for  the  milder  cases ;  but  when  the  udder  is  much  swollen, 
it  becomes  a  duty  to  relieve  the  animal  of  the  increase  of  weight 
— which  of  itself  is  a  source  of  much  suffering — by  the  applica- 
tion of  a  broad  bandage,  made  so  as  to  envelope  the  whole  gland, 
and  fastened  over  the  back.  This  bandage  can  be  made  to  con- 
tain a  poultice ;  and  if  holes  be  cut  in  it  for  the  passage  of  the 
teats,  there  will  be  no  necessity  to  remove  it  when  it  is  desirable 
to  milk  the  cow.  The  best  material  for  a  poultice  in  cases  of 
this  kind  is  spent  hops.  They  are  very  light,  contain  much 
moisture,  and  can  be  easily  changed  when  necessary ;  they  are 
also  very  soothing,  and  do  not  irritate  when  they  become  dry. 
The  udder  is  to  be  rubbed  with  the  extract  of  belladonna,  which 
also  may  be  dissolved  and  mixed  with  the  poultice.  The  bella- 
donna serves  a  twofold  purpose ;  it  allays  the  pain  and  irrita- 
tion, and,  by  relaxing  the  sphincter  of  the  teat,  allows  the 
spontaneous  escape  of  the  milk.  If  suppuration  occur,  the 
abscesses  are  to  be  opened,  the  pus  allowed  to  escape,  and  the 
wounds  dressed  with  mild  astringent  antiseptics. 

Gangrene  of  the  gland  may  necessitate  the  removal  of  the 
dead  portion  by  excision ;  but  before  using  the  knife  the  practi- 
tioner must  ponder  over  the  probabilities  of  the  case.  The 
late  Mr.  Barlow  recommended  early  excision.  I  am,  however, 
of  opinion  that  this  should  not  be  done,  for  the  dead  parts,  if 
time  be  allowed,  will  separate  from  the  living,  and  are  then 
easily  removed  by  moderate  traction;  the  foetor  of  the  dis- 
charges being  in  the  meantime  modified  by  deodorising  agents, 
as  Condy's  fluid,  carbolic  acid,  chloride  of  zinc,  or  the  hyposul- 
phite of  soda,  and  the  animal's  strength  supported  by  good  food, 
milk,  eggs,  as  well  as  ale  or  stout,  and  the  appetite  stimulated 
by  stomachics. 

2t 


CHAPTER  XXXVL 

CASTRATION. 

CASTRATION — PRECAUTIONS  TO  BE  OBSERVED   BEFORE  THE  OPERATION 

IS    PERFORMED METHODS     OF     OPERATING CONSEQUENCES      OF 

CASTRATION — SWELLING HERNIA SCIRRH OUS  CORD — FISTULA 

07   THE    SCROTUM PERITONITIS — GA»GRENE TETANUS PARA- 
LYSIS— AMAUROSIS — GLANDERS  AND  FARCY. 

The  operation  bj  wliicli  the  horse  is  emasculated  is  generally 
performed  upon  him  when  he  is  about  one.  year  old,  and  at  a 
season  of  the  year  when  the  weather  is  neither  too  hot  nor  too 
cold ;  the  latter  end  of  April  or  the  beginning  of  May  "is  the 
period  generally  fixed  upon.  This  time  of  the  year  and  the 
age  of  the  animal  are  sanctioned  by  universal  custom,  and  for 
the  reasons  that  the  colt  is  sufficiently  strong  to  bear  the 
operation  without  much  danger,  and  that  the  young  grass  is 
becoming  ready  for  him  when  he  has  recoi^ered.  Colts  thin  and 
'low  in  the  neck  should  form  exceptions  to  the  general  rule, 
and  ought  to  be  allowed  a  few  months  more  time  "  to  furnish " 
before  being  operated  upon. 

Precautions  to  he  observed  hefoi^e  operating. — 1st.  To  examine  the 
scrotum,  in  order  to  ascertain  if  hernia  be  present,  and  whether 
the  testicles  have  descended,  for  in  some  instances,  either  from 
narrowness  of  the  inguinal  canal,  deficiency  of  force  in  the  con- 
traction of  the  gabernaculum  testes,  or  some  other  cause,  the 
testicles,  or  one  of  them,  may  be  retained  in  the  abdominal 
cavity. 

2d.  Not  to  operate  upon  a  thin,  weakly  colt,  nor  upon  one 
suffering  from  any  disease. 

od.  Not  to  operate  during  very  cold  weather,  when  an 
easterly  wind  is  blowing,  nor  in  sultry  w^eather,  when  Hies 
prevail. 


PRECAUnOXS  BEFORE  OPERATING.  643 

4dli.  Not  to  operate  upon  an  animal,  of  any  age,  which  is 
confined  in  an  ill-ventilated,  ill-drained,  or  otherwise  unhealthy- 
shed  or  stable ;  nor  upon  one  stabled  along  with  a  great  number 
of  horses. 

bth.  To  recommend  that  all  colts  intended  for  the  operation 
should  have  a  daily  allowance  of  corn  for  a  few  weeks  prior  to 
being  cut. 

^th.  To  be  very  careful  that  all  the  instruments  required  for 
the  operation  be  scrupulously  clean,  and  the  scalpels  sharp. 

Ith.  If  the  practitioner  has  conducted  a  post-mortem  examina- 
tion of  any  animal,  or  has  attended  a  case  of  parturition,  or  has 
performed  any  operation  calculated  to  produce  a  taint  that  may 
cling  to  his  clothes,  hands,  or  instruments,  he  is  to  delay 
performing  the  operation  of  castration  for  at  least  one  day 
thereafter. 

This  last  precaution  is  very  important,  and  I  may  add  to  it^ 
that  colts  should  not  be  cut  near-  the  dissecting-room  of  any 
veterinary  college. 

Pre2oaratioii  for  the  Operation. — If  the  colt  be  in  good  con- 
dition, and  fit  for  the  operation,  he  is  mei:ely  to  be  kept  short 
of  bulky  food,  and  to  be  stinted  in  his  water  for  a  few  hours 
prior  to  the  operation.  It  is  a  mistake  to  starve  the  animal 
for  a  day  or  two,  as  is  the  custom  in  some  districts ;  and  he 
should  have  a  small  feed  of  corn  on  the  morning  prior  to  being 
cut.  If  the  colt  be  not  in  condition  for  the  operation,  it  must 
not  be  performed  for  some  weeks,  the  animal  to  be  well  fed  in 
the  meantime. 

In  the  c^se  of  an  older  animal,  which  has  covered  or  has 
been  otherwise  worked  before  being  cut,  no  preparation  is 
necessary,  provided  he  is  in  working  condition;  but  if  he  is 
fat,  has  been  standing  idle  for  some  time,  or  from  other  causes 
is  out  of  working  condition,  he  should  be  prepared  by  one  or 
two  purgative  doses,  regular  exercise,  and  good  hard  food.  It 
is  an  error  to  suppose  that  the  strength  and  vital  powers  of  a 
horse  should  be  reduced  before  he  is  operated  upon.  He  cannot 
possess  too  much  health  and  strength.  In  fact,  a  horse,  to 
stand  an  operation  well,  ought  to  be  in  the  condition  of  a  prize- 
fighter when  prepared  for  battle. 

The  animal — whatever  his  age  may  be — being  deemed  in 
fit  condition  for  the  operation,  the  practitioner  will  proceed  to 


644  CASTRATION. 

cast  him  for  the  operation,  and  administer  chloroform  if  thought 
expedient.  As  most  operators  have  a  way  of  their  own,  I  need 
not  describe,  in  a  book  of  this  kind,  how  it  ought  to  be  done, 
except  indeed  that  I  cast  animals  of  all  ages  for  this  operation 
with  the  ropes,  that  I  throw  them  upon  the  near  side,  and  that 
I  sometimes  operate  without  turning  upon  the  back,  and  with- 
out including  the  fore  feet  in  the  ropes.  In  cases,  however, 
where  the  testicles  are  very  small  and  difficult  to  get  at,  I  find 
it  necessary  to  turn  the  animal  upon  his  back. 

The  animal,  being  now  prepared  for  the  final  act  of  the  opera- 
tion may  be  deprived  of  his  testicles  in  a  variety  of  ways,  which  I 
need  not  describe,  as  I  consider  that  the  most  humane  way  is  the 
best  of  all  ways,  and  that  is  the  operation  by  torsion,  performed 
as  follows : — The  operator  is  to  be  provided  with  two  clams,  one 
made  of  two  pieces  of  smooth  rounded  iron,  jointed,  the  other  of 
flattened  steel,  as  represented  in  the  drawing. 


Fig.  114. 

The  operator  having  grasped  the  testicle  intended  to  be  first 
removed — and  it  is  good  practice  to  remove  the  smaller  one 
first,  when  the  colt  is  young,  or  the  one  farthest  away  if  they  are 
both  of  a  good  size — wdth  his  left  hand,  is  to  secure  it  in  position 
by  passing  the  smooth  clam  round  the  scrotum,  so  as  to  press 
the  skin  upon  the  spermatic  cord,  and  thus  prevent  the  with- 
drawal of  the  testicle  by  the  cremaster  muscle  when  the  incision 
is  being  made.  When  the  testicle  is  firmly  included  in  the 
clam,  the  scrotal  skin  is  to  be  pulled  tight  over  it,  and  the 
incision  made  close  to  the  raphe,  and  low  down  towards  the 
sheath,  in  order  to  allow  the  escape  of  all  subsequent  discharges, 
and  prevent  swelling.  The  incision  is  to  be  made  with  a  bold 
sweep  of  the  scalpel,  and  is  to  be  at  least  three  inches  long,  when 
the  testicle  will  generally  pop  out.  The  smooth  clam  is  now  to 
be  removed,  and  the  flat  clam — serrated  upon  its  edges — ap- 
plied to  the  spermatic  cord,  above  the  epididymus,  and  securely 


METHODS   OF  OPEEATIXG.  645 

fastened  by  pulling  its  handles  together  and  fastening  them  with 
the  slide.  The  testicle  being  now  firmly  secured,  the  operator 
is  to  divide  the  non-vascular  posterior  part  of  the  cord,  close 
to  the  surface  of  the  clam  and  above  the  epididymus,  by 
running  a  sharp  knife  flatwise  upon  the  clam,  taking  care, 
however,  not  to  cut  beyond  what  is  seen  to  be  white  and 
bloodless,  and  leaving  the  testicle  and  vascular  cord  untouched 
Avith  the  knife.  The  vascular  portion  of  the  cord  is  now  to  be 
firmly  embraced  with  the  torsion  forceps  as  close  as  possible  to 


Fig.  115.  — Torsion  forceps. 

the  surface  of  the  clam,  and  the  testicle  cut  off  within  about  an 
inch  from  the  forceps.  The  forceps — the  grasp  of  which  having 
been  fixed  by  the  screw — is  now  to  be  turned  slowly  round 
with  the  right  hand  of  the  operator,  the  left  being  engaged  in 
keeping  the  clam  steady,  when  it  will  be  seen  that  the  tissues 
of  the  cord  quickly  give  way,  until  the  spermatic  artery  alone 
remains  ;  this  gives  way  more  slowly,  and  very  frequently  will 
remain  unbroken  till  it  is  drawn  out  as  small  as  a  piece  of 
thread.  In  some  instances  it  will  be  found  necessary  to  re- 
apply the  torsion  forceps  after  a  few  turns  have  been  made, 
owing  to  the  cord  commencing  to  give  way  at  a  distance  from 
the  clam,  which — if  not  prevented  by  the  reapplication  of  the 
forceps — would  leave  a  quantity  of  ^bruised  tissue  attached  to 
its  extremity. 

It  is  important  that  but  as  little  as  possible  of  the  cord, 
bruised  by  the  forceps,  should  be  left  attached,  and  that  the 
cord  should  be  made  to  break  across  as  near  to  the  clam  as  pos- 
sible. It  is  also  important  to  bear  in  mind  that  the  forceps 
should  be  turned  slowly  and  steadily,  rapid  jerking  twists  being 
calculated  to  rupture  the  artery  before  its  coats  are  sufficiently 
bruised.  When  the  division  of  the  artery  is  complete,  the  clam 
is  to  be  slowly  removed,  the  cord  allowed  to  escape  into  the 
scrotum,  and  the  other  testicle  operated  upon.     I  have  operated 


646  CASTRATION. 

by  this  method  for  the  last  fourteen  years,  and  always  with  satis- 
factory results. 

The  operation  by  ligature  of  the  artery  seems  the  most  surgical 
and  humane,  but  experience  has  proved  that  it  is  the  most 
unsuccessful  of  all  methods.  The  late  Professor  Dick  recom- 
mended the  ligature  for  a  number  of  years ;  but  towards  the  end 
of  his  life  he  was  forced  to  acknowledge,  and  frankly  did  so,  that 
it  was  attended  with  frequent  fatal  results,  the  very  presence  of 
the  ligature  seemingly  inducing  a  prejudicial  effect,  irritating  the 
cord,  and  causing  peritonitis  or  abscesses. 

When  hernia  is  present,  operation  by  torsion  is  inadmissible, 
that  by  the  clam  being  the  only  method  which  can  be  performed 
with  safety ;  and  what  is  termed  the  "  covered  operation," 
namely,  that  in  which  the  tunica  vaginalis  is  left  undivided 
with  the  knife,  and  dissected  from  the  scrotum,  has  been  recom- 
mended. I  consider  this  method  a  very  undesirable  one,  and 
calculated  to  be  succeeded  by  unsatisfactory  results ;  and  even 
if  it  were  always  successful,  I  fail  to  see  the  advantage  of  dis- 
secting the  skin  and  dartos  muscle  from  the  tunica  vaginalis, 
and  making  a  wound  that  is  sure  to  suppurate  profusely,  when 
a  much  more  simple  method,  namely,  that  of  including  the 
scrotum  in  a  plain  clam,  can  be  easily  performed.  I  therefore 
strongly  recommend  that  when  a  hernia  is  present,  the  intestine 
should  be  returned  into  the  abdomen,  and  the  scrotum  and  its 
contents  upon  the  side  of  the  hernia  included  in  a  strong 
wooden  clam  (not  a  caustic  calm),  placed  as  close  to  the  external 
ring  as  possible,  and  the  whole  mass  allowed  to  slough.  In  this 
way  no  incisions  are  made,  no  painful  dissections;  and  the 
barrier  to  the  descent  and  escape  of  the  intestines,  by  the  skin 
being  included  in  the  adhesive  process,  is  much  stronger  than 
when  it  consists  of  the  serous  tunics  only. 

In  castrating  aged  horses  particularly,  it  is  often  found  that 
the  testicle  has  become  firmly  adherent  to  the  scrotum,  generally 
at  the  inferior  and  the  posterior  part  of  the  testicle. 

If  the  adhesion  be  slight  it  can  be  broken  down  easily ;  but  in 
some  cases  it  is  so  extensive  as  to  render  this  an  impossibility, 
and  the  operator  is  compelled  to  dissect  the  adhesion  until  the 
cord  is  clearly  reached. 

Mr.  Collins  recommends  that  the  covered  operation  be 
performed   when   the   tunics   are  much  thickened.     Why  not 


METHODS  OF  OPERATING.  647 

include  the  scrotum,  and  thus  do  away  with  the  necessity  for 
dissection  ? 

In  some  cases  one  or  both  testicles  will  be  imperfectly 
developed,  small,  and  almost  beyond  the  operator's  reach ;  but 
by  careful  traction  they  may  be  included  in  the  clam  and 
removed. 

THE   CONSEQUENCES  OF  CASTRATION. 

Tliese  are  either  favourable  or  unfavourable,  normal  or 
abnormal.  The  normal  or  natural  results  are,  a  varying  but 
slight  degree  of  inflammation,  some  swelling,  and  a  discharge 
of  serum  or  pus. 

The  swelling  which  succeeds  the  operation  varies  very  much 
in  different  subjects ;  in  some  limited  to  the  sheath,  and  con- 
sisting of  a  mere  serosity ;  whilst  in  others  it  extends  along  the 
floor  of  the  abdominal  walls,  even  as  far  forward  as  the  sternum. 
This,  however,  need  cause  no  alarm,  so  long  as  the  animal  eats 
well,  and  usually  a  few  punctures  with  the  lancet  will,  by 
allowing  the  serosity  to  drain  away,  cause  its  disappearance  in  a 
day  or  two  ;  but  when  the  cord  becomes  tumefied  to  any  great 
extent,  alarming  consequences  may  be  apprehended,  and  endea- 
vours must  be  made  to  suppress  the  inflammation  by  fomenta- 
tions with  warm  water  to  the  part,  assisted  by  the  administration 
of  sedatives  and  febrifuges. 

Some  operators  are  in  the  habit  of  applying  irritant  ointments 
to  the  divided  end  of  the  cord  immediately  after  the  operation, 
in  order,  as  they  say,  to  produce  a  discharge  of  matter.  This  is 
a  very  reprehensible  practice,  and  calculated  to  inflict  much 
pain.  There  is  no  necessity  for  the  establishment  of  any  suppu- 
rative action ;  indeed,  the"  very  fact  of  there  being  any  suppura- 
tion at  all,  indicates  that  an  amount  of  inflammation,  calculated 
to  retard  the  healing  process,  has  been  excited  by  the  operation, 
and  instead  of  irritating  the  parts  with  abominable  mixtures, 
such  as  sulphuric  acid,  olive  oil  and  turpentine,  it  is  the  duty  of 
the  practitioner  to  perform  the  operation  in  such  a  manner  as  to 
cause  but  the  slightest  possible  degree  of  pain,  and  to  do  nothing 
liaving  a  tendency  to  retard  the  process  of  repair  by  the  adhe- 
sive inflammation. 

It  will  be  found  occasionally  that  the  edges  of  the  wounds 
unite  in  a  very  short  time  after  the  operation,  and  that  a  consi- 


648  CASTRATION. 

derable  effusion  into  the  scrotal  sac  subsequently  occurs.  In 
such^  the  rule  of  non-interference  must  be  slightly  departed 
from,  and  it  becomes  necessary  to  apply  warm  fomentations  tc 
the  part,  in  order  to  soften  and  separate  the  united  edges,  and 
allow  the  escape  of  the  incarcerated  serosity ;  but  even  in  such 
instances  the  fomentations  need  not  be  repeated. 

The  inauspicious  consequences  of  castration  are,  hernia, 
scirrhous  cord  or  champignon,  peritonitis,  gangrene,  tetanus, 
amaurosis,  glanders,  and  farcy. 

Hcemorrliage  need  not  occur  if  the  operation  be  properly 
performed ;  a  shght  degree  of  bleeding  from  the  vessels  of  the 
■scrotum  is  of  no  consequence,  except  when  it  occurs  in  lambs. 
In  these  animals  even  a  very  slight  amount  of  bleeding  into 
the  scrotum  is  followed  by  very  serious  consequences ;  indeed, 
this  sometimes  causes  a  great  fatality  amongst  lambs  castrated 
in  the  months  of  September  and  October.  It  sets  up  a  very 
high  degree  of  erysipelatous  inflammation  in  the  cord,  extending 
to  the  peritoneum,  which,  along  with  the  cord  and  surrounding 
structures,  speedily  becomes  gangrenous.  The  blood  imprisoned 
in  the  scrotum  of  the  lamb,  decomposing  very  rapidly,  seems  to 
exert  a  toxic  effect  upon  the  surrounding  tissues,  therefore  great 
care  must  always  be  taken  that  the  operation  is  performed  with- 
out hsemorrhage  ;  and  for  this  reason  I  am  of  opinion  that  the 
scrotum  of  lambs  five  or  six  months  old  should  be  opened  with 
the  actual  cautery,  and  all  bleeding  thus  prevented. 

The  admission  of  air  into  the  peritoneal  sac,  which  often  occurs 
when  the  horse  rises  after  the  operation,  and  is  demonstrable 
by  a  rusliing  or  gurgling  sound,  never  does  any  harm.  Indeed, 
air  must  always  be  admitted  into  the  peritoneal  sac,  and  the 
instances  mentioned  where  the  sound  often  causes  much  alarm 
differ  from  others  merely  in  such  admission  being  accompanied 
by  a  rushing  noise. 

Farcy  and  glanders  occasionally  result  from  castration ;  but 
they  are  merely  accidental,  and  depend  upon  the  animal 
being  predisposed  prior  to  the  operation,  or  that  he  has  been 
subjected  to  some  taint  immediately  subsequent  to  its  per- 
formance. 

Paralysis  is  also  recorded  as  a  result;  and  in  all  proba- 
bility it  is  due  to  some  injury  to  the  vertebra3  or  muscles  of 
the  back  or  loins,  occurring  wliilst  the  animal  is  secured  for 
operation. 


CONSEQUENCES  OF  CASTRATION.  649 

Tetanus  may  result  from  castration,  although  the  operation 
has  been  carefully  performed.  It  happens  here  as  it  does  when 
caused  by  any  wound  or  injury,  and  the  operator  cannot  be  held 
responsible,  although  attempts  have  been  made  to  recover 
damaG^es  when  death  has  so  occuiTed. 

Amaurosis. — This  complication  has  been  observed  by  several 
writers,  but  in  every  instance  the  horse  has  been  subjected  to 
improper  treatment  shortly  after  the  operation,  or  the  haemor- 
rhage has  been  excessive.  In  some  instances  sight  has  been 
restored  in  a  few  days,  whilst  in  others  the  animal  has  remained 
permanently  blind. 

Hernia  after  castration  has  been  already  noticed. 

Champignon,  scirrJms  of  the  cord,  or  sarcocele,  arises  from  cas- 
tration with  the  caustic  clam,  when  the  operator  has  neglected, 
while  removing  the  clam,  to  separate  the  adhesions  which 
always  take  place  between  the  cord  and  the  lips  of  the  wound ; 
from  castration  with  the  actual  cautery  when  the  cord  has  been 
left  too  long,  or  when  the  crem aster  muscle  has  suffered  from 
some  debility,  and  the  extremity  of  the  cord  has  remained  in 
contact  with  the  wounded  scrotum,  or  has  slightly  protruded 
beyond  the  opening.  Mr.  Percivall,  translating  D'Arboval, 
gives  an  extended  account  of  this  affection ;  but  it  is  evident 
that  neither  he  nor  his  French  authority  had  ever  considered 
the  above-mentioned  causes.  In  order  to  prevent  scirrhus  of 
the  cord,  it  is  necessary  when  the  operation  is  performed  by  the 
clam,  that  the  operator  should  introduce  his  finger  into  the 
wound,  and  gently  separate  the  cord  from  the  scrotum,  by 
tearing  the  adhesions  asunder,  and  pushing  the  cord  upwards 
towards  the  abdominal  ring.  There  is  no  difficulty  in  eff'ect- 
ing  this  at  the  time  the  clam  is  removed,  the  material  consti- 
tuting the  adhesions  being  of  a  non-vascular,  easily  lacerable 
nature ;  whereas,  if  the  separation  be  not  effected,  the  end  of 
the  cord,  imprisoned  in  the  scrotal  wound,  and  subjected  to 
sources  of  irritation,  becomes  inflamed,  and  finally  constitutes 
a  fibro-vascular  mass,  sometimes  attaining  the  size  of  a  man's 
head,  forming  a  fungous  tumour  several  pounds  in  weight.  Mr. 
Percivall  states  that  the  tumour  varies  in  size  and  form ;  some- 
times its  largest  part  is  below,  sometimes  above.  In  my  own 
experience,  the  tumour  has  been  largest  below,  appearing  as  a 
cauliflower  excrescence  on  the  cut  end  of  the  cord,  the  cord 


650  CASTRATION. 

itself  being  at  the  same  time  much  swollen,  indurated,  and 
iirmly  adhering  to  the  surrounding  structures.  The  presence  of 
the  tumour,  and  the  pain  from  the  inflammation  of  the  part, 
cause  the  animal  to  become  stiff  during  progression,  and  to 
draw  up  the  leg  of  the  affected  side  whilst  standing;  to  be 
"  tucked-up  in  his  flank,"  to  lose  his  appetite,  and  present  other 
signs  of  constitutional  disturbance.  Occasionally  the  limb  be- 
comes swollen  from  an  erysipelatous  inflammation,  with  much 
lameness,  and  a  tendency  to  suppuration  of  the  inguinal 
glands.  Should  both  cords  be  diseased,  all  the  above  symptoms 
are  aggravated ;  the  animal  no  longer  lies  down,  but,  as  Mr. 
Percivall  states,  "  continues  to  be  preyed  upon  by  an  exhaust- 
ing suppuration  and  fever,  which  bring  on  marasmus  and  death. 
The  cord  on  dissection  appears  solid,  thick,  and  scirrhous,  and  as 
large  as  a  man's  arm,  all  the  way  from  the  wound  to  the  loins, 
with  vessels  in  it  the  size  of  one's  finger,  and  divers  abscesses, 
full  of  black,  sanious,  fcetid  matter ;  the  kidney,  haunch,  and 
thigh  of  the  same  side  containing  fistulous  ulcerations;  the 
bladder  having  the  appearance  of  a  scirrhus;  in  fine,  all 
the  surrounding  parts  participating  more  or  less  in  the  dis- 
org:anization." 

I  have  made  the  above  quotation  from  Percivall  for  the 
reason  that  I  have  never  had  an  opportunity  of  maldng  a  post 
mortem  examination  of  a  case  of  scirrhus  of  the  cord. 

Treatment. — ^Acting  upon  the  conclusion  that  the  fungous 
growth  proceeds  from  peripheral  irritation,  and  not  from  intrinsic 
causes,  as  previous  disease  of  the  cord,  or  the  tubercular  or 
cancerous  diathesis,  the  practitioner  will  lose  no  time  in  remov- 
ing as  much  of  the  mass  as  he  possibly  can  reach  with  the 
knife.  I  have  operated  repeatedly  and  successfully,  and  have 
proceeded  as  follows  : — The  animal  being  cast,  I  have  dissected 
the  tumour  from  the  surrounding  scrotum,  as  high  up  as  |)os- 
sible,  sometimes  removing  a  portion  of  skin  about  half-an-inch 
in  breadth  along  with  the  diseased  mass ;  then  having  fairly 
separated  it  from  the  healthy  structures,  I  have  placed  the  flat 
clam,  Fig.  114,  upon  the  cord,  as  near  the  abdominal  ring  as 
possible,  and  have  removed  the  tumour  by  very  slow  torsion, 
twisting  it  slowly  round  with  the  hand,  until  it  has  completely 
given  way.  There  has  been  no  hoemorrhage,  although  I  have 
removed  a  champignon  between  six  and  seven  pounds  in  weight 


CONSEQUENCES  OF  CASTRATION.  651 

by  tliis  method.  Mr.  Percivall,  quoting  from  D'Arboval, 
recommends  the  ligature,  and  when  the  scirrhus  has  extended 
along  the  cord  too  high  up  to  be  included  in  the  ligature — a 
fact,  he  says,  "  that  may  be  ascertained  by  manual  examination, 
per  rectum,  and  that  the  cord  itself  is  indurated,  and  increases 
in  volume  upwards,  and  has  contracted  adhesions  with  the 
surrounding  parts,  and  is  likely  to  degenerate  into  a  cancerous 
mass,  reaching  from  the  scrotum  to  the  loins,  other  means 
must  be  sought.  One  resource  is  left  us,  that  of  piercing  or 
boring  the  cord  with  a  red-hot  iron  of  sufficient  length,  and 
straight,  and  about  the  diameter  of  the  finger.  The  scirrhous 
cord  is  to  be  drawn  forth  to  the  extent  that  it  will  bear  by  an 
assistant,  w^ho  at  the  same  time  diverges  the  lips  of  the  wound, 
while  the  operator  plunges  the  cautery  into  the  scirrhus,  and 
thrusts  it  longitudinally  through  it ;  he  may  likewise  cauterise 
its  sides  both  within  and  without  the  scrotum ;  the  object  being 
to  induce  a  suppurative  process  which  may  consume  it."  With 
every  due  deference  to  Mr.  Percivall,  and  to  the  authorities 
from  whom  he  quotes,  I  think  this  a  very  barbarous  method, 
irrational  in  principle,  and  cruel  in  application;  I  look  upon 
the  growth  of  the  fungus  to  be  due  to — except  in  the  instances 
above  mentioned,  and  which  may  be  set  down  as  incurable  by 
any  external  application  or  operation — the  irritation  of  the 
dividend  extremity  of  the  cord  being  kept  up  by  its  adhesion  to 
the  wound  in  the  scrotum.  When  the  source  of  irritation  no  ^ 
longer  continues,  and  its  removal  is  effected  by  excision  of  the 
tumour,  the  inflammation  of  the  cord,  and  all  accompanying 
symptoms  will  gradually  subside.  In  fact,  the  continuance  and 
growth  of  the  tumour  depend  upon  a  cause  analogous  to  that 
wliich  produces  proud-flesh  in  a  wound,  namely,  irritation. 


CHRONIC  SUPPURATION,  OR  FISTULA  OF  THE  SCROTUM. 

I  have  frequently  met  with  cases  of  a  chronic  induration  of 
the  cord,  seemingly  arising  from  the  same  cause  as  champignon, 
namely,  adhesion  to  the  scrotal  wounds,  in  geldings  of  various 
ages.  In  such,  the  cord  is  hard,  and  enlarged  within  the  scrotum, 
and  from  time  to  time  suppuration  occurs  within  its  substance ; 
abscesses  form  and  discharge  an  unhealthy  purulent  matter. 
The  formation  of  these  abscesses  occurs  periodically,  and  may 


652  CASTRATION. 

"be  induced  by  very  trivial  exciting  causes,  such  as  a  common 
cold,  or  a  hard  day's  work.  The  cord  then  inflames,  the  animal 
becomes  lame,  stiff,  feverish,  and  unfit  for  work,  and  will 
occasionally  remain  in  this  condition  for  several  weeks  after  the 
abscesses  have  discharged  their  contents.  Geldings  subject  to 
this  affection  are  generally  unthrifty,  go  wide  behind,  and  with 
a  degree  of  stiffness  in  their  gait.  They  are  unsound,  and 
should  the  veterinarian  be  called  upon  to  examine  a  case  of  this 
kind,  even  months  after  the  animal  has  been  purchased,  he 
need  not  hesitate  to  certify  as  to  the  unsoundness,  provided 
he  can  discover  that  the  animal  has  had  abscesses  upon  a 
previous  occasion ;  and  tliis  can  always  be  done  by  examination 
of  the  scrotum,  upon  the  surface  of  which  depressed  cicatrices, 
indicating  the  seat  of  former  abscesses,  will  be  found. 

The  treatment  is  removal  of  the  diseased  cord  by  torsion. 

A  case  is  reported  by  Mr.  Percivall  of  a  tumour  of  the  cord, 
from  this  cause,  weighing  twenty-nine  pounds. 


PERITONITIS. 

Inflammation  of  the  peritoneum  may  manifest  itself  as  early 
as  the  second  day  after  castration  has  been  performed.  It  is 
generally  due  to  one  of  the  following  causes : — The  prevalence 
of  easterly  winds ;  exposure  to  cold ;  the  animal  being  unfit  for 
operation,  by  either  being  too  fat  or  too  lean;  dividing  the 
cord  too  high  up ;  or  it  may  originate  from  some  constitutional 
tendency  to  inflammatory  disease  when  all  external  circum- 
stances are  good. 

The  symiotoms  are  those  of  dejection  and  dulness  rather  than 
of  acute  pain;  the  animal  seems  to  suffer  most  excruciating 
agony,  but  is  too  depressed  or  too  much  afraid  to  express  his 
suffering  in  the  usual  manner.  If  there  are  colicky  pains,  their 
manifestation  continues  but  for  a  short  period,  and  gives  way  to 
great  depression;  the  animal  standing  almost  immoveable;  a 
tucked-up  and  tense  abdomen ;  hurried  breathing ;  quick,  hard, 
wiry,  rapid  pulse ;  coldness  of  the  extremities ;  rapid  sinking, 
and  death  ;  occasionally  the  animal  becomes  delirious,  or  coma- 
tose and  paralysed. 

Traumatic  peritonitis  is  an  inflammation  partaking  of  the 
nature  of  erysipelas,  spreading  rapidly  from  its  point  of  origin 


CONSEQUENCES  OF  CASTRATION.  653 

over  the  whole  surface  of  the  serous  membrane.  The  disease  is 
accompanied  by  a  low  adynamic  form  of  fever ;  changes  in  the 
blood  are  induced  by  which  its  various  constituents  become 
broken  up,  and  discharged  by  the  urinary  organs,  tinging  the 
urine  a  dark  red  or  coffee  colour. 

Upon  a  post  mortem  examination  being  made  of  an  animal 
which  has  died  from  this  form  of  peritonitis,  the  small  intestines, 
and  sometimes  the  stomach  and  large  ones,  will  be  found  to 
contain  large  quantities  of  this  altered  blood,  passive  hgemor- 
rhage  into  the  canal  having  occurred  prior  to  death.  It  has  the 
appearance  of  very  dark  red,  or  reddish-brown,  ill-made  coffee, 
containing  the  grounds. 

While  the  intestinal  canal  is  thus  partly  filled  with  altered 
blood,  the  surface  of  the  peritoneum  presents  a  variety  of 
appearances.  In  some  parts  it  is  studded  with  dark  red  spots, 
whilst  in  other  parts  it  is  covered  by  an  exudation  of  an  aplastic 
nature.  Surrounding  the  abdominal  ring,  a  diffuse  dark  red 
blush  is  generally  seen,  extending  over  more  or  less  surface,  as 
the  case  may  be.  In  some  instances  the  exudation  of  lymph 
has  been  abundant,  and  bands  of  false  membranes  may  be  seen 
uniting  the  intestines  to  each  other,  and  to  the  abdominal  walls; 
whilst  others  are  characterised  by  effusion  of  a  turbid  serosity 
more  than  by  exudation  of  lymph.  Several  quarts  or  gallons  of 
serum  will  often  be  found,  although  the  animal  has  been  ill  but 
for  a  few  hours.  In  places,  the  congested  vessels  of  the  peri- 
toneum present  a  streaky  appearance,  but  what  is  properly 
termed  congestion  is  never  very  strongly  marked ;  this  is  in  all 
probability  due  to  the  readiness  with  which  effusion  and  exuda- 
tion take  place;  the  intense  dark  red  colour,  found  here  and 
there  over  the  surface  of  the  membrane,  having  more  of  the 
characters  of  ecchymosis  or  gangrenous  extravasations  than  of 
true  congestive  spots.  When  the  intestinal  convolutions  are 
separated  from  each  other,  a  film  of  exudation  is  seen  to  extend 
across  the  interspace,  and  it  is  seen  that  the  exudation  collects 
in  the  furrow  between  the  convolutions  of  the  various  intestines 
more  abundantly  than  elsewhere.  The  effusion  is  often  mixed 
with  loose  flakes  of  coagulable  lymph,  and  it  seldom  presents 
the  straw  colour  of  a  true  serous  effusion,  being  generally  tinged 
with  blood,  or  containing  iU-conditioned  purulent  matter,  which 
gives  it  a  dirty  grey,  or  even  greenish  hue. 


654  CASTRATION. 

Treatment. — Generally  the  disease  terminates  fatally  in  a  few 
hours,  and  may  be  considered  as  beyond  the  reach  of  remedial 
measures ;  but  if  any  treatment  is  to  be  adopted,  it  must  be  that 
calculated  to  soothe  and  support, — opium,  stimulants,  and  the 
application  of  hot  water  to  the  abdomen,  succeeded  by  mustard. 
Bleeding,  purgatives,  and  depressants  are  inadmissible.  The 
remarks  of  Mr.  Ferguson  of  Dublin  upon  the  treatment  of  peri- 
tonitis are  very  pertinent,  and  ought  to  be  carefully  studied  by 
veterinary  surgeons.  They  are  to  the  effect  that  peristaltic  action 
and  movement  of  the  bowels  should  be  arrested  by  opium  in 
peritonitis  (see  Veterinarian  for  1871).  If  the  above  remedies 
are  ineffectual,  the  probabilities  of  a  favourable  termination  are 
very  remote ;  but  should  the  acute  symptoms  yield,  great  care 
must  still  be  taken  that  the  patient  be  subjected  to  no  cause  by 
which  a  relapse  may  be  induced.  Purgatives  must  be  withheld ; 
the  food  must  be  of  the  most  easily  digested  nature.  Boiled 
linseed,  with  bran  well  soaked  in  boiling  water,  answers  admir- 
ably, as  it  is  calculated  to  keep  the  faeces  pultaceous  without 
producing  increase  of  the  peristaltic  action  of  the  bowels. 


CHAPTEE  XXXYII. 

DISEASES    OF     THE    SKIN. 

CLASSIFICATION WILL  AN  AND  BATEMAN's,  BENNETT'S,  AND  BUCH- 
ANAN'S CLASSIFICATIONS ERYTHEMATOUS  INFLAMMATIONS — CLIP- 
PING HORSES HERPES — URTICARIA. 

An  essay  was  read  a  short  time  ago  at  a  provincial  veterinary 
association  by  a  veterinary  surgeon,  who  stated  that  Professor 
Spooner,  in  his  lectures,  instructed  his  class  to  the  effect  that  if 
aU  the  skin  diseases  of  the  horse  were  put  in  a  sack  and  shaken 
up,  they  would  turn  out  to  be  mange.  With  all  due  deference 
to  the  essayist,  I  must  demur  from  his  conclusions ;  and  from 
much  observation,  I  am  in  a  position  to  state  that  true  mange 
is  a  rare  disease  in  this  country. 

In  the  human  being  diseases  of  the  skin  are  so  numerous  and 
so  important  as  to  demand  a  speciality  of  study ;  but  in  the 
lower  animals  they  are  found  to  be  much  simpler  in  their  nature, 
fewer  in  their  varieties,  and  more  amenable  to  treatment.  At 
the  same  time,  many  of  them  bear  so  close  a  resemblance  to 
those  of  man,  that  a  classification  based- upon  the  researches  of 
the  more  recent  dermatologists,  may  with  advantage  be  adopted 
by  the  veterinary  surgeon. 

There  are  three  classifications : — 1st.  The  artificial  one  of 
Willan,  Bateman,  and  others ;  2d.  The  natural  arrangement 
of  Alibert  and  others;  and  3d.  A  pathological  classification, 
founded  on  the  supposed  morbid  lesions;  but  of  these  the 
classification  of  Willan  and  Bateman  is  considered  the  best 
for  practical  purposes.  It  is  comprehended  in  the  following 
definitions  of  terms  in  common  use  in  the  description  of  skin 
diseases : — 


656  DISEASES  OF  THE  SKIN. 

Order  1.  Pimples. — Papulce  are  simple,  solid  acuminated  eleva- 
tions  of  the  cuticle,  resembling  an  enlarged  j:?api7Zrt  of  the  skin.  They 
commonly  terminate  in  a  scurf,  and  sometimes,  though  seldom,  in 
slight  ulcerations  on  their  summits. 

V 

Order  2.  Scales. — Squamce  consist  of  cuticle  in  patches,  plates, 
or  laminae,  in  wliich  the  epidermic  cells  are  morbidly  adherent,  hard, 
thickened,  whitish,  and  opaque.  These  scales  cover  either  small 
papillae,  red  elevations,  or  larger  deep-red  and  dry  surfaces. 

Order  3.  Eashes. — Exanthemata  are  composed  of  variously  formed, 
irregular  sized,  superficial  red  patches,  which  dis-appear  under  pressure, 
and  terminate  in  desquamation. 

Order  4.  Blebs. — Biillce.  These  differ  from  vesicles  in  their  size, 
a  large  portion  of  the  cuticle  being  detached  from  the  skin  by  the 
interposition  of  a  watery  fluid,  usually  transparent.  The  skin  is  red 
and  inflamed  underneath  the  blister. 

Order  5.  Pustules. — Pustulce  consist  in  circumscribed  elevations 
of  the  cuticle,  and  contain  pus.  They  have  red  and  inflamed  bases, 
and  are  succeeded  by  an  elevated  scab,  wliich  may  or  may  not  be  fol- 
lowed by  a  cicatrix. 

Order  6.  Vesicles. —  Vesiculce,  small  acuminated  or  orbicular  ele- 
vations of  the  cuticle,  containing  lymph,  which,  at  first  clear  and 
colourless,  may  become  amber-coloured,  opaque,  or  pearl-like.  They 
are  succeeded  by  a  scurf  or  a  laminated  scab. 

Order  7.  Tubercules. — Tuherculce,  small,  hard,  indolent  elevations 
of  the  skin,  sometimes  suppurating  partially,  sometimes  idcerating  at 
their  summits. 

Order  8.  Spots. — Maculce  are  permanent  discolorations  or  stains 
of  some  portions  of  the  skin,  often  with  a  change  of  structure.  They 
may  be  whitish,  dusky,  or  dark. 

Dr.  Bennett  has  expunged  Bidlcc  from  these  orders,  and  added 
two  others,  namely,  those  which  depend  upon  the  presence 
of  parasitic  animals  and  plants,  and  wdiich  he  calls  respec- 
tively Dermatozoa  and  Dcrmatophyta.  His  classification  is  as 
follows : — 


I 


CLASSIFICATION. 


657 


Order  I.  Exanthemata. 

Erythema. 

Eoseola. 

Urticaria. 

Order  II.  Yesicul-s:. 
Eczema. 
Herpes. 
Scabies. 
Pemphigus. 

Order  III.  Pustul^b. 
Impetigo. 
Ecthyma. 
Acne. 
Eupia. 

Order  IV.  Papulj:. 
Lichen. 
Prurigo. 

Order  Y.  Squaile. 
Psoriasis. 


Pityriasis. 
Ichthyosis. 

Order  YI.  TuBERCULiE. 
Lepra  Tuberculosa. 
Lupus. 
MoUuscumu 

Order  YII.  Macule. 

Lentigo. 
Ephelides. 
Naevi. 
Purpura. 

Order  YIII.  Dermatozoa. 
Entozoon  foUiculorum. 
Acarus. 
Pediculus. 

Order  IX.  Dermatophyta. 

Achorion  Schonleinii. 

„  Grubii. 

(Mentagra.) 


Objection  is  taken  to  these  forms  of  classification  upon  the 
grounds  that  they  are  mainly  anatomical,  and  that  they  throw 
no  light  on  the  causes,  the  pathology,  or  the  treatment  of  the 
various  diseases.  "Febrile  diseases  are  associated  with  the 
non-febrile,  and  local  and  trivial  ailments  are  associated  with 
those  of  grave  import.  They  entirely  overlook  the  circum- 
stance that  what  may  be  papular  to-day  may  be  vesicular  to- 
morrow, and  pustular  eventually.  And,  on  the  other  hand, 
distempers  which  nature  has  plainly  brought  together,  and 
connected  by  striking  analogies  and  resemblances,  are  by  these 
arrangements  put  widely  asunder." — (Watson.) 

The  late  Dr.  Buchanan,  of  Glasgow,  in  a  paper  "On  the 
Theory  and  Classification  of  Inflammation  of  the  Skin,"  says 
that  skin  diseases,  like  all  other  diseases,  ought  to  be  classified 
according  to  their  nature  or  pathology ;  but  when  the  cause  is 
unknown,  some  other  principles  must  be  sought  for,  under 
which  groups  may  be  formed ;  and  he  finds  that  in  the  patho- 
logical processes  recognised  as  inflammations^  new  formatioThs, 

2u 


658  DISEASES  OF  THE  SKIN. 

and  hcemorrhages,  skin  diseases  may  be  arranged  into  three  or 
more  groups. 

Classification  of  Skin  Diseases. — (Dr.  Buchanan.) 

Class  I. — Inflammations. 
Group  I. — Simple  inflammations  (allied  to  simple  dermatitis). 

(1.)  Erythema — (a),  simplex;  (h),  multiforme;  (c),  chronicum 
— comprehending  papulatum,  nodosum,  strophulus, 
squamosum,  pityriasis,  fur/uracea,  membranacea, 
rubra. 

(2.)  Herpes  (simplex  and  zoster). 

(3.)  Urticaria  (idiopatliic,  from  indigestion  of  particular 
kinds  of  food ;  from  uterine  aff'ections,  or  persistent). 

(4.)  Dermatitis  (idiopathic,  as  from  burns,  or  from  frost- 
bite ;  or  symptomatic,  as  of  erysipelas ;  or  phlegmon- 
odes,  as  furunculus,  anthrax,  Aleppo  tubercle). 

(5.)  Pemphigus  (benign,  persistent,  and  foliaceous). 

Group  IL — Eczematous  inflanmiations  (allied  to  eczema). 

(1.)  Eczema  (erythematodes ;  E.  papulosum — comprising 
lichen  simplex,  and  prurigo  ;  E.  vesicular e  ;  E.  rubrum  ; 
E.  pustulosum — comprising  impetigo  sparsa,  figuratis, 
and  pilaris;  E.  lichen;  E.  squamosum;  E.  pityriasis), 

(2.)  Acne  (comprising  A.  simplex;  A.  pilaris ;  A.  rosacea). 

(3.)  Ecthyma — (a),  simplex;  (b),  chronicum,  rupia ;  (c), 
gangrenosum. 

(4.)  Psoriasis  (punctata,  guttata,  nummularis,  circinata, 
(lepra),  gyrata,  conjluens). 

Group  III. — Ulcers. 

(1.)  Idiopathic. 
(2.)  Sympathetic. 
(3.)  Constitutional. 

Class  II. — New  Formations. 

Group  I. — Homologous  I^ew  Formations. 

(1.)  Epidermic   (epithelial    growths,  comprising   callosities, 

clavus,  ichthyosis,  cornucutaneum). 
(2.)  Pigmentary  {lentigo,  ephelis,  moles,  melanosis,  chloasmat 

silver  stain,  leucopathia). 


CLASSIFICATION.  659 

(3.)  Dermic  (cicatrix  normal,  or  cheloid,  cutaneous  tumours 
(wens),  multiple  tumours  {mycosis),molluscum  simplex, 
condylomata,  verruca  vulgaris,  verruca  mollis). 

Group  II. — Heterologous  !N"ew  Formations. 

(1.)  Pseudoplasms  {lupus — comprehending  maculosus,  tuher- 
culosuSy  hypertrophicus,  exedens,  serpiginosus ;  and 
lepra — comprehending  maculosa,  tuberculosa,  ances- 
thetica,  exulcerans). 

(2.)  Neoplasms  {epithelioma,  carcinoma). 

Class  III. — Haemorrhages,  e.g.,  Petechice,  Vihices, 
Ecchymosis,  Purpura. 

Class  IV. — Diseases  of  Accessory  Organs,  e.g.,  Hair,  Nails, 

Sweat  Glands. 

Class  V. — Diseases  defined  hy  Uniform  Causes. 

Group  I. — Parasitic  diseases. 
„     II. — Syphilitic  eruptions. 
„   III. — Eruptions  of  Specific  Fevers, 
„    IV. — Scrofulodermata. 

The  classification  of  Dr.  Buchanan,  containing  though  it  does 
many  diseases  of  the  skin  which  are  never  seen  amongst  the 
lower  animals,  is  yet  that  best  adapted  for  the  purposes  of 
description ;  and  although  I  have  given  the  table  in  its  entirety, 
I  intend  to  describe  in  the  text  those  diseases  only  to  which  the 
lower  animals  are  liable. 


ERYTHEMATOUS  INFLAMMATIONS. 
(1.)  ERYTHEMA, 

Inflammation  of  the  outer  layer  of  the  dermis,  including  not  only 
the  slight  inflammation  produced  by  mildly  irritating  agents, 
such  as  rubefacients,  cold,  stings,  &c.,  but  also  spontaneous 
inflammations  depending  on  systemic  or  constitutional  distur- 
bances. Its  character  or  expression  is  that  of  uniform  redness, 
(but  the  redness  can  only  be  seen  in  the  colourless  skin,  such  as 
white  heels  of  horses,  and  mammary  glands  of  cows),  with  heat, 
swelling,  and  irritation. 


660  DISEASES  OF  THE  SKIN. 

The  causes  of  erythema  are  cold  and  heat  operating  alternately 
on  the  skin ;  wet,  friction,  dirt,  pressure,  and  constitutional 
causes,  such  as  hereditary  predisposition,  debilitating  diseases, 
plethora,  and  poverty.  There  are  three  forms  of  erythema 
described  by  some  writers.  An  examination  of  the  divisions 
will  at  once  show  the  reader  that  the  causes  are  described  as  the 
diseases.  Thus,  erythema  intertrigo  is  a  superficial  inflamma- 
tion of  the  skin,  produced  by  a  chafe,  gall,  or  fret,  induced  by 
friction  of  one  part  of  the  skin  against  the  other,  by  the  har- 
ness, or  by  the  irritation  of  urinary  discharges  flowing  over  the 
skin,  as  when  an  animal  is  long  confined  in  the  slings,  when 
suffering  from  cystic  calculus,  or  any  cause  of  non-ability  to 
urinate  properly.  Again,  erythema  paratrimma  means  erythema 
from  pressure,  such  as  saddle-galls;  and  erythema  chronicum 
includes  cracked  heels,  and  chapped  teats  of  newly-calved  cows 
and  ewes.  I  refer  to  this,  in  order  to  explain  to  the  reader  the 
various  methods  adopted  in  describing  skin  diseases. 

Erythema,  as  seen  in  the  horse,  may  be  divided  into  acute  and 
chronic  ;  the  latter  form  being  that  commonly  witnessed  in 
long-standing  "  cracked  heels  "  of  horses,  where  the  skin  presents 
upon  its  surface  bran-like,  scaly  crusts,' the  limbs  swelling  more 
or  less  at  night,  and  the  animal  evincing  perhaps  a  slight  stiffness 
in  gait  when  first  moved  in  the  morning,  but  no  suppuration. 

An  acute  form  of  erythema  is  often  witnessed  in  prolonged 
wet  weather,  involving  the  limbs  to  a  considerable  extent ;  some- 
times all  the  four  legs,  arms,  thighs,  and  surface  of  the  abdomen 
are  covered  over  by  patches  of  superficial  inflammation.  This 
disease  is  generally  known  under  the  elegant  and  euphonious 
term  of  "  mud-fever."  It  is  caused  by  the  irritation  of  wet  dirt, 
and,  I  was  going  to  say,  negligent  grooming,  but  a  circumstance 
has  just  lately  come  to  my  knowledge  that  compels  me  to 
hesitate.  It  will  be  generally  known  that  the  winter  of  1871 
was  a  very  wet  one,  and  consequently  mud-fever  a  very  prevalent 
disease.  Speaking  one  day  to  a  large  cab-proprietor  and  job- 
master in  this  city,  and  casually  referring  to  the  prevalence 
of  sore  legs  from  this  disease,  he  informed  me  that  none  of  his 
cab-horses  were  so  affected,  whilst  his  job-horses  were  all  more 
or  less  so.  The  reasons  he  gave  were  that  the  cab-horses  were 
never  groomed  at  night :  that  they  came  in  at  all  times,  dirty 


ERYTHEMA.  GGl 

and  wet,  were  turned  into  tlieir  stables,  but  never  groomed  till 
the  morning  ;  the  dirt  was  then  dry,  and  was  brushed  off ;  whilst 
his  best  horses  (out  on  job  in  gentlemen's  carriages),  which  came 
in  early  and  had  their  legs  washed,  dressed,  bandaged,  and  other- 
wise made  comfortable,  were  all  affected  with  sore  legs. 

Mud-fever  is  occasionally  attended  by  a  considerable  degree 
of  systemic  disturbance  (hence  the  term,  I  suppose),  ex- 
cessive lameness  from  irritation  and  pain,  and  desquamation 
of  large  patches  of  the  skin;  occasionally  it  is  several  weeks 
before  recovery  takes  place.  Even  after  the  febrile  symptoms 
have  disappeared,  an  amount  of  unthriftiness  continues ;  the  hair 
and  cuticle  come  off  in  patches  on  various  parts  of  the  body ; 
the  appetite  remains  capricious,  and  any  condition  which  the 
horse  may  have  previously  possessed  soon  disappears.  Now 
and  then  limited  suppurations  occur  in  the  flexures  of  the  knees, 
hocks,  and  pasterns. 

Mr.  Broad,  of  Bath,  writes  to  me  as  follows : — "Mud-fever. — 
The  plan  of  clipping  the  hair  with  the  clipping  machine,  from 
off  the  legs  especially,  is  the  predisposing  cause,  as  it  leaves 
the  skin  so  bare  that  it  cannot  so  readily  resist  the  effects  of 
irritants  of  any  kind  as  when  protected  by  its  natural  covering. 
The  hot  water  washing  opens  the  pores  of  the  skin,  and  a  free 
secretion  sets  in,  which,  however,  becomes  suddenly  checked 
from  the  clothing  and  bandages  not  being  put  on  before  the 
vessels  of  the  skin  become  congested,  and  subsequently  inflamed ; 
hence  the  disease.  The  horse  is  often,  after  washing,  imme- 
diately led  from  the  hot  steaming  stall  or  wash-house  into  the 
open  air  to  his  box,  the  temperature  of  which  is  very  low ;  and 
in  other  cases  he  is  exposed  to  currents  of  cold  air  from  the 
opening  of  doors  during  the  process.  There  is  also  another  very 
common  and  bad  practice — that  of  thoroughly  wetting  all  the 
legs  at  the  commencement  of  the  washing,  so  that  the  water 
may  run  on  to  the  feet  to  moisten  the  dirt  and  render  them 
more  easily  cleaned.  Mud-fever  may  occur  after  washing  with 
cold  water,  but  not  with  proper  and  ordinary  attention  to 
clothing  and  bandaging.  I  have  never  known  it  to  occur  when 
the  mud  has  been  allowed  to  become  dry  and  then  well  brushed 
off  without  the  application  of  water ;  not  even  when  the  horses 
liave  been  hunted  in  districts  supposed  to  cause  it.  My  opinion 
of  the  mud  of  the  supposed  blistering  districts  is  that  it  is  there 


662  DISEASES   OF  THE  SKIN". 

more  plentiful,  and  of  a  more  sticky  character,  consequently 
requiring  a  longer  and  more  extensive  application  of  the  hot 
washing  process.  As  preventives,  allow  the  hair  to  remain  on 
the  legs  from  the  upper  part  of  the  hocks  and  knees  downwards, 
wash  with  cold  water,  clothe,  and  bandage. 

"I  strongly  condemn  the  practice  of  washing  hunter's  legs 
before  they  return  to  their  stables,  as  I  also  do  that  of  carriage 
and  hack  horses  when  left  at  hotel  stables  for  an  hour  or  two,  as 
in  such  cases  they  are  never  rubbed  dry  or  bandaged ;  the  result 
is  often  either  cracked  heels  or  mud-fever. 

"  Treatment. — Mix  eight  parts  of  glycerine  and  one  of  plumbi 
dia.  sol.,  and  apply  once  or  twice  daily ;  give  walking  exercise, 
and  seldom  will  there  be  any  other  medical  treatment  required." 

Treatment  of  Erythema. — In  limited  erythema,  aperients,  rest, 
poultices  to  the  parts,  succeeded  by  diuretics,  tonics,  and  the 
local  application  of  zinc  ointment,  or^  what  is  very  useful,  a 
thick  liniment  made  by  adding  two  ounces  of  liquor  plumbi  to 
six  or  eight  ounces  of  olive  oil.  The  cause,  in  the  acute  as  well 
as  in  the  more  chronic  form,  must  be  inquired  into,  and,  if 
possible,  removed.  Chronic  erythema  requires  to  be  treated 
by  astringents,  avoidance  of  moisture,  diuretics,  tonics ;  and, 
should  these  fail,  the  part  is  to  be  pencilled  over  with  a  solution 
of  nitrate  of  silver  (one  drachm  to  the  ounce  of  water) ;  or  a  mild 
blister  is  to  be  applied,  and  the  system  generally  altered  by 
the  administration  of  the  liquor  arsenicalis  for  several  days  or 
weeks. 

In  the  more  diffuse  form  the  whole  of  the  parts  affected  are 
to  be  fomented  with  warm  water,  and  dressed  over  with  the  zinc 
or  lead  preparation :  bandages  do  harm.  The  constitutional 
treatment: — Purgatives,  febrifuges,  diuretics,  succeeded  by 
tonics ;  and  should  the  case  be  obstinate,  arsenic  or  quinine. 

Horses,  when  clipped  very  closely,  and  since  machine  clipping 
has  become  general,  suffer  very  frequently  from  the  disease, 
which  manifests  itself  as  a  diffuse  form  of  erythema  a  few  days 
after  the  operation.  The  inflammation  extends  over  the  greater 
part  of  the  surface  of  the  body,  and  terminates  in  a  few  days  in 
small  patches  of  desquamation  of  the  cuticle  and  hair.  Before 
clipping  machines  were  used,  a  form  of  erythema  was  found, 
resulting  from  the  effects  of  the  singeing  which  generally  com- 
pleted the   operation   imperfectly  performed   by  the    scissors. 


ERYTHEMA.  663 

TLis  was  even  m-acli  more  formidable  than  that  met  with  now- 
a-days.  If  there  be  much  pain  and  irritation  of  the  skin,  and  if 
the  animal  be  afraid  of  his  harness,  and  easily  galled  by  the 
collar  or  saddle,  a  few  days'  rest  is  to  be  prescribed,  together 
with  fomentations  to  the  parts  affected  ;  and  the  following  lotion 
applied  : — ^  Plumbi  acet.  §i,  aqua  Oj. ;  or  the  ordinary  white 
lotion  may  be  used. 

With  reference  to  the  clipping  of  horses,  I  am  of  opinion  that 
it  is  a  great  advantage ;  they  work  better  after  being  clipped ; 
thrive  on  less  food ;  are  less  liable  to  disease ;  are  stronger, 
healthier,  and  more  cheerful ;  and,  when  sick,  recover  in  a  much 
shorter  time.  It  is  not  my  intention  to  discuss  the  question  ;  I 
merely  wish  to  counteract  a  ridiculous  idea  propounded  by  Mr. 
Gamgee,  that  clipping  is  injurious  to  the  horse. 

I  strongly  recommend  the  Irish  method  of  clipping,  namely, 
clipping  all  parts  of  the  body  except  the  legs.  The  hair  that  is 
left  on  the  legs  protects  them  from  the  irritation  of  wet  and  dirt; 
and,  when  horses  are  used  for  hunting  purposes,  from  the  pene- 
tration of  thorns,  &c. 


ERYTHEMA  MAMMILARUM. 

This  is  not  a  rare  variety  of  erythema,  and  is  seen  in  the  cow, 
affecting  the  cutaneous  covering  of  the  mammary  gland ;  some- 
times associated  with  inflammation  and  swelling  of  the  gland 
substance ;  at  other  times  uncomplicated.  It  presents  itself  as 
a  diffuse  redness,  with  heat  and  pain  of  the  skin.  It  is  gene- 
rally met  with  about  the  time  of  parturition,  and  is  best  treated 
by  a  mild  cathartic,  and  the  local  application  of  a  cooling 
lotion. 


(2.)   HERPES. 

"  This  disease  is  expressed  by  patches  of  irregular  form  and 
variable  size,  upon  each  of  which  there  arises  a  group,  cluster, 
or  crop  of  vesicles.  It  is  often  preceded  by  considerable  local 
irritation,  cutaneous  pain,  or  neuralgia,  which  sometimes  remains 
after  the  eruption  has  died  away.  The  vesicles  ultimately  rup- 
ture, and  a  gum-like  scab  forms  over  the  group,  which  shrivels 
and  contracts  upon  itself." — (Aitken.)     The  clusters  vary  much 


664  DISEASES  OF  THE  SKIN. 

in  size,  and  the  vesicles  are  larger  than  those  of  eczema ;  they 
do  not  burst  so  quickly,  and  their  contents  rapidly  become 
milky.  A  common  seat  of  herpes  is  the  upper  lip,  constituting 
what  Professor  Dick  called  "  crusta  labialis ;"  occasionally  it  is 
seen  on  the  skin  surrounding  the  hoof,  and  it  is  then  called 
herpes  coronalis,  or  crown  scab.  It  begins  with  some  heat,  and 
redness,  should  the  skin  be  white,  on  a  small  patch,  upon  the 
surface  of  which  the  vesicles  appear. 

Herpes  is  found  in  the  mouth,  on  the  mucous  membrane  of 
the  rectum,  vagina,  and  in  the  interdigital  space  of  horned  cattle, 
sheep,  and  pigs ;  in  the  so-called  epizootic  aphtha,  eczema 
epizootica,  and  murrain,  or  foot-and-mouth  disease. 

During  the  prevalence  of  some  epizootic  diseases  amongst 
horses,  groups  of  large  vesicles  form  on  the  face,  lips,  even  within 
the  mouth,  and  on  the  mucous  membranes.  The  vesicles  are  only 
seen  at  their  outset,  because  the  epithelium  retains  the  fluid  ex- 
uded under  it  but  for  a  very  short  time,  so  that  a  white  spot  is  left, 
produced  by  maceration  of  the  epithelium,  or,  if  this  be  removed, 
a  shallow  excoriation.  No  crust  is  formed,  owing  to  the  con- 
stant soaking  of  the  parts  in  saliva  and  mucus. 


HERPES  CIPtCINATUS,  OR  VESICULAR  RING- WORM. 

There  are  two  forms  of  ring-worm  in  the  horse — a  non-con- 
tagious form,  the  herpes  circinatus  ;  and  a  contagious  ring-worm, 
tinea  tondens,  or  furfaceous  herpes,  which  will  be  described 
hereafter. 

Herpes  circinatus  is  an  eruption  of  vesicles  upon  inflamed 
patches  of  skin,  which  assume  a  circular  form.  The  circles  are 
of  varying  size,  and  sometimes  enclose  an  area  of  healthy  skin. 
They  increase  in  size  by  their  circumference. 

In  very  slight  attacks  the  vesicles  are  very  small,  and  their 
contents  are  disposed  of  by  absorption,  the  eruption  terminating 
by  desquamation. 

Causes. — Some  disturbance  of  the  digestive  functions,  or 
irritation  of  the  respiratory  mucous  membrane;  the  eruption 
being  an  effort  of  the  system  to  eliminate  some  disposition  to 
internal  disease.  Horses  which  have  been  lately  imported  from 
Ireland  are  very  subject  to  this  form  of  herpes ;  it  seems  to 
depend  upon  a  general  disturbance  of  the  system,  brought  about 
by  the  sea  voyage. 


HERPES  CmCINATUS.  665 

Treatment. — If  very  slight,  little  or  no  treatment  is  necessary. 
The  parts  may  be  covered  over  with  the  lead  liniment,  and  a 
diuretic  given;  but  when  the  vesicles  are  large,  the  base  in- 
flamed, and  the  animal  disposed  to  rub  himself,  a  smart  cathartic 
is  to  be  administered,  the  parts  bathed  with  the  acetate  of  lead 
lotion,  and  should  there  be  excoriations,  an  ointment  of  nitrate 
of  silver,  ten  grains  to  the  ounce  of  lard,  should  be  used.  If  the 
eruption  be  associated  with  debility,  as  is  commonly  the  case 
in  young  horses  which  have  passed  through  an  attack  of  a  de- 
bilitating disease,  tonics  and  good  food  are  to  be  prescribed.  Mr. 
Erasmus  Wilson  recommends  that  when  herpes  has  become 
chronic,  a  blister  should  be  applied. 

(3.)    UETICARIA — NETTLE-RASH — SURFEIT. 

This  is  a  frequent  form  of  skin  disease  in  the  horse,  and  con- 
sists of  an  eruption  of  elastic  eminences,  roundish  or  oblong  in 
shape,  and  attended  with  itching. 

The  lumps  rise  quickly,  and  upon  the  greater  part  of  the  body, 
generally  beginning  upon  the  neck,  and  frequently  disappearing 
as  suddenly  as  they  come.  They  are  unequal  in  size  ;  some  like 
hemp-seed,  others  as  large  as  beans,  and  flattened  upon  their 
surface. 

The  peculiarity  of  this  form  of  eruption  is  its  suddenness.  I 
have  often  seen  the  lumps  appear  upon  all  parts  of  the  body  in 
the  course  of  a  few  minutes.  It  is  caused  by  some  disorder  of 
the  digestive  apparatus,  and  is  sometimes  preceded  by  colic  and 
diarrhoea. 

A  sudden  change  of  diet  will  frequently  produce  it,  and  it  is 
not  at  all  uncommon  when  horses  are  first  fed  on  grass.  It  is 
supposed  that  poisonous  herbs,  a  draught  of  cold  water  when  the 
animal  is  heated,  sudden  exposure  to  cold  and  damp,  and  calculi 
or  worms  in  the  intestines,  are  causes  of  it. 

Treatment. — ^As  a  rule,  this  is  a  very  simple  matter,  a  mild 
purgative  being  all  that  is  necessary.  Should  there  be  much 
itchiness — the  animal  rubbing  itself — the  skin  must  be  bathed 
with  warm  water,  dressed  with  the  acetate  of  lead  lotion,  and 
low  diet  prescribed  for  a  few  days. 

Dr.  Maclagan  reports  the  analysis  of  the  urine  in  a  case  of 
urticaria,  in  which  there  was  deficiency  of  urea  and  uric  acid, 


666  DISEASES  OF  THE  SKIN. 

"  We  venture  to  propose,  as  the  pathological  view  of  the  case. 
that  the  defect  was  a  deficiency  of  the  products  of  the  transfor- 
mation of  the  tissues,  and  that  the  retention  in  this  way  in  the 
system  of  matters  which  ought  to  be  eliminated  from  it  might 
be  the  cause  of  the  cutaneous  eruption." — (Edinhurgh  Monthly 
Journal?)  If  this  be  the  correct  view  of  the  pathology  of  urti- 
caria, good  results  may  be  expected  from  the  administration  of 
colchicum  in  obstinate  or  recurring  nettle-rash. 

In  some  cases  of  nettle-rash  desquamation  of  the  cuticle  and 
hair  occurs ;  and,  what  is  very  peculiar,  the  hair  never  assumes 
its  original  colour,  but  remains  white  on  the  seat  of  the  rash,  the 
animal  being  ever  afterwards  spotted  upon  those  parts  where 
the  rash  was  situated. 


CHAPTER  XXXYIII. 

DISEASES  OF  THE  SKIN — continued. 

DEFINITION — DIVISION — VARIOUS  FORMS  OF  ECZEMA — SIMPLEX — RUB- 
RUM LICHEN IMPETIGINODES ACUTE  AND  CHRONIC  GREASE 

ELEPHANTIASIS CRUSTA  LABIALIS TREATMENT    OF  ECZEMATOUS 

ERUPTIONS — EFFECTS  OF  CARBOLIC  ACID  ON  THE  DOG. 

ECZEMATOUS  INFLAMMATIONS. 

The  majority  of  skin  diseases,  particularly  in  the  horse,  are  due 
to  the  expression  of  some  form  of  eczema ;  indeed,  we  may  look 
upon  it  as  the  commonest  skin  disease. 

Eczema,  as  defined  by  Willan  and  Bateman,  is  "  an  eruption 
of  minute  vesicles,  not  contagious,  crowded  together,  and  which, 
from  the  absorption  of  the  fluid  they  contain,  form  into  thin 
flakes."  There  is  first  an  erythematous  state  of  the  skin,  with 
heat,  tingling,  and  itching,  soon  followed  by  the  formation  of 
vesicles  ;  and  the  elementary  lesions  of  the  skin  in  eczema  may 
be  divided  as  follows  : — (1),  An  erythematous  condition  of  the 
skin  ;  (2),  vesicles  ;  (3),  pustules ;  (4),  -  papules  ;  (5),  fissures ; 
(6),  a  mixture  of  several  or  of  all  these  lesions. 

The  vesicles,  when  they  occur,  are  usually  developed  at  the 
orifices  of  the  cutaneous  follicles,  are  easily  ruptured,  and  dis- 
charge an  albuminous  alkaline  fluid,  which  is  glutinous  and 
irritating  to  the  skin.  When  the  vesicles  are  not  ruptured,  they 
terminate  by  absorption  of  the  fluid ;  but  the  disease  does  not 
often  come  to  an  end  with  the  drying  up  of  one  crop  of  vesicles. 
More  commonly,  the  eruption  is  successive,  and  crop  after  crop 
of  vesicles  is  formed ;  or  the  surface,  on  which  they  first 
appeared,  remains  red  and  raw,  and  continues  to  discharge  a 


668  DISEASES   OF  THE  SKIN. 

fluid  resem"bling  that  contained  in  the  vesicles.  After  the 
disease  has  existed  some  time,  there  is  a  thickening  of  the 
derma,  which  becomes  corrugated,  more  especially  in  those  parts 
of  the  body  where  the  skin  is  naturally  loose  and  moveable. 

The  individual  vesicles  of  eczema  do  not  last  long,  and  in 
some  cases  no  vesicles  are  found ;  but  the  skin  is  inflamed,  and 
fissures  make  their  appearance  in  the  epidermis.  These  fissures 
are  at  first  superficial^  but  become  deeper  if  the  disease  con- 
tinues. This  form  has  been  called  by  Dr.  Buchanan  eczema 
rimosum ;  and  in  the  horse  it  affects  the  flexures  of  the  knees 
and  hocks,  termed  respectively  mallenders  and  sallenders,  by 
horsemen  and  farriers.  Eczema  characterised  by  fissures  is 
generally  a  chronic  form  of  the  disease,  and  when  affecting  the 
limbs  it  has  been  designated  by  Greve,  Fsmasis  caiyi  et  tarsi. 


VARIOUS  FORMS  OF  ECZEMA. 
(1.)  ECZEMA  SIMPLEX,  HUMID  TETTER, 

A  non-contagious  disease,  usually  commencing  about  the  neck, 
shoulders,  back,  and  thighs.  It  usually  comes  on  suddenly,  and 
is  manifested  by  itchiness,  which  causes  the  animal  to  rub  and 
bite  itself  until  the  hair  and  cuticle  are  brought  off,  leaving 
the  skin  red,  raw,  and  inflamed.  Successive  crops  of  vesicles 
develop  themselves,  dry  on  the  sore  skin,  or  discharge  a  fluid 
which  seems  to  cause  an  extension  of  the  disorder.  The  parts 
of  the  body  most  usually  affected  are  those  which  are  covered 
by  the  saddle  or  harness  ;  but  it  may  affect  any  part,  such  as 
the  head,  neck,  quarters,  thighs,  and  fore-arms.  It  is  generally 
called  mange,  but  it  differs  from  true  scabies  in  two  essential 
particulars,  namely,  it  is  not  contagious,  and  does  not  depend 
upon  the  presence  of  a  parasite. 

Eczema  simplex  is  sometimes  very  troublesome  and  difficult 
to  treat.  In  some  horses  it  occurs  periodically,  or  when  an 
alteration  is  made  in  the  diet.  As  a  rule,  it  is  a  summer  disease, 
prevailing  in  the  warmer  months ;  but  in  a  few  cases  which 
have  come  under  my  notice,  it  has  been  developed  in  the  winter 
only,  and  when  the  horses  were  clipped.  These  are  very 
exceptional  and  peculiar  cases,  clipping  in  other  instances 
favouring  the  disappearance  of  the  disease.     Eczema  simplex 


ECZEMA  SBIPLEX.  669 

is  very  common  in  Edinburgh,  and  most  usually  attacks  dray 
and  farm  horses.  In  the  winter  months  it  attacks  horses  fed 
upon  boiled  food,  meal-seeds  (husks  of  oats),  or  coarse  straw. 
In  the  summer,  horses  well  cared  for  are  subject  to  it  when 
first  put  on  green  food,  and  almost  invariably  an  animal  which 
has  suffered  from  one  attack  is  liable  to  a  recurrence. 

In  such  instances  eczema  occurs  symptomatically  as  a  conse- 
quence of  some  constitutional  disturbance.  In  other  cases,  the 
disease  is  induced  by  the  direct  application  of  irritants,  heat, 
cold,  strong  ointments  of  sulphur,  tar,  and  blisters. 

It  may  attack  several  animals  at  the  same  establishment,  and 
this  may  lead  one  to  suppose  that  it  is  true  scabies ;  but  it  is 
not  so,  and  the  reason  why  several  animals  are  thus  attacked 
is  explainable  by  the  fact  that  they  are  all  partaking  of  the 
same  kind  of  food,  and  subjected  to  the  same  treatment  in 
other  ways. 

This  form  of  eczema  is  generally  considered  to  be  true  conta- 
gious mange ;  but  I  am  satisfied,  from  extensive  opportunities  of 
carefully  noting  the  disorder,  that  it  is  not  so ;  and  although  it 
may,  and  often  does,  attack  a  number  of  animals  simultaneously, 
it  is  generally  confined  to  a  few  in  the  same  stud,  and  these 
will  suffer  for  months  without  communicating  the  disease  to 
others.  If  the  history  of  an  outbreak  amongst  a  number  be 
inquired  into,  it  will  usually  be  found  that  there  has  been  a 
sudden  change  of  diet. 

(2.)  ECZEMA  EUBRUM, 

The  red  mange  of  dogs,  in  which  there  is  an  eruption  (due  to  a 
parasite,  see  Scabies)  of  vesicles  on  a  very  red  inflamed  skin ; 
the  redness  is  best  seen  in  white  dogs.  It  is  usually  confined 
to  the  thighs,  belly,  and  chest.  In  chronic  cases  the  skin  be- 
comes tumefied  and  corrugated  at  the  parts  affected. 

Mr.  PercivaU,  in  his  work  on  the  effects  of  medicines,  says 
that  ''a  form  of  eczema  similar  to  the  red  mange  is  induced 
by  the  incautious  apphcation  of  mercurial  ointment  to  the  skin, 
accompanied  by  loss  of  appetite,  salivation,  closure  of  the  eye- 
lids, great  dulness,  foetid  exhalations  from  the  skin  and  mouth, 
and  sometimes  death." 

A  considerable  number  of  cases  of  this  form  of  eczema  has 


670  DISEASES   OF  THE  SKIN. 

been  recorded  as  occurring  in  cattle  and  dogs  ;  and  in  books  on 
skin  diseases  it  is  described  as  eczema  mercuriale.  I  have  seen 
it  result  from  the  irrational  administration  of  hydrargum  cum 
creta. 

(3.)   LICHEN 

Is  a  papular  form  of  eczema ;  the  eruption,  commencing  as  small 
papules  either  isolated  or  confluent,  and  becoming  excoriated, 
discharges  a  serous  fluid,  which  ultimately  concretes  into  a 
crust.  This  form  is  confined  to  the  legs  of  horses,  and  situated 
along  the  course  of  the  flexor  tendons.  Sometimes  all  four  legs 
are  affected,  frequently  one  or  two ;  and  from  the  peculiarity  of 
appearance  it  gives  to  the  legs  the  disease  is  known  as  "  Eat 
tails."  This  appearance  is  due  to  an  exudation  around  the  hair 
follicles  ;  the  hairs  remain  unchanged,  except  from  friction,  and 
emerge  from  an  elevated  papulae,  giving  to  the  leg  an  appear- 
ance of  being  covered  by  the  tails  of  rats. 

(4.)   ECZEMA  IMPETIGINODES,  OR  PUSTULOSIBI. 

"In  eczema  impetiginodes  the  skin  is  highly  inflamed  and 
swollen ;  the  vesicles,  which  in  many  places  are  aggregated  into 
confluent  clusters,  often  communicate  with  each  other,  and  form 
a  continuous  vesicle  of  some  extent.  Their  contents,  at  first 
limpid,  speedily  become  turbid  and  puriform,  and  in  a  short 
space  of  time  are  effused  upon  the  surface  by  rupture  of  the 
epidermis.  The  purulent  secretion,  after  its  effusion,  concretes 
upon  the  broken  surface,  and  produces  yellowish  laminated 
crusts,  often  of  considerable  extent.  When  the  crusts  are  rubbed 
off  or  removed,  the  exposed  surface  of  the  derma  presents  a 
vivid  crimson  colour,  partly  concealed  here  and  there  by  films 
of  whitish  lymph,  and  secreting  an  abundant  ichorous  fluid 
having  a  reddish  tinge.  This  secretion  hardens,  if  the  inflamed 
surface  be  exposed  to  the  influence  of  the  atmosphere,  into  a 
tliin  dark-coloured  scab,  which  remains,  unless  disturbed  by 
accident  or  design,  until  the  excoriated  surface  is  healed. 

"The  eruption  of  eczema  impetiginodes,  as  of  the  milder 
forms  of  eczema,  is  successive ;  fresh  crops  of  pustular  vesicles 
are  produced  as  the  first  decline,  and  in  this  way  the  disease  is 
prolonged,  especially  if  irritated  by  the  employment  of  injudi- 
cious remedies.  In  the  latter  case  the  affection  often  lapses 
into  the  chronic  form  of  eczema." — (Wilson.) 


ECZEMA  IMPETIGINODES.  671 

This  form  of  eczema  is  frequently  seen  in  the  horse,  under 
the  well-known  appellation  of  "  grease,"  which  may  be  defined 
to  be  an  inflammation  of  the  skin  at  the  back  of  the  heels  and 
fetlocks,  where  vesicles  and  pustules  form,  yielding  a  foetid 
discharge.  The  disease  is  sometimes  associated  with  febrile 
disturbance.  In  some  instances,  swelling  of  the  limb  or  limbs 
affected  may  precede  the  eruption  ;  whilst  in  others,  the  eruption 
2)recedes  the  swelling.  The  hind  limbs  are  more  frequently 
affected  than  the  fore  ones.  The  discharge  is  sometimes  very 
profuse,  and  it  is  said  that  it  is  capable  of  inducing  an  eruption 
in  cows  and  human  beings  similar  to  that  of  variola ;  on  this 
account  it  has  been  termed  equine  lymph. 

I  am  of  opinion  that  the  evidence  as  to  the  specific  character 
of  this  equine  lymph  is  not  sufficient  to  warrant  a  conclusion, 
and  that  the  subject  is  deserving  of  further  investigation. 

The  discharge  from  the  pustules  and  vesicles  of  grease  irritates 
the  surface  over  which  it  flows;  and  the  skin  of  the  heels 
— which  in  health  is  peculiarly  soft  and  pliable — becomes 
rigid ;  the  natural  sebaceous  secretion  of  its  follicles  is  arrested, 
and,  as  a  consequence,  the  movements  of  the  limb  cause  the 
skin  to  crack,  and  to  become  a  mass  of  soreness,  ulceration,  and 
fungus,  accompanied  by  heat,  pain,  and  lameness.  When  the 
disease  is  of  this  type,  it  is  very  apt  to  assume  a  chronic  char- 
acter. The  febrile  symptoms,  along  with  the  heat,  pain,  and 
lameness,  diminish;  but  the  swelling  still  continues,  and  the 
skin  is  constantly  moist  and  greasy  from  the  discharge,  which 
is  thick,  foetid,  and  mats  the  hairs  together.  Masses  of  fungoid 
granulations  now  appear,  springing  from  the  unhealthy  sores, 
consisting  of  hypertrophied  papillae,  covered  over  by  abnormal 
horny  scales  of  epithelium,  loosely  attached  to  their  surfaces, 
easily  rubbed  off,  and  exposing  a  highly-vascular  sensitive 
surface  beneath,  which  bleeds  at  the  slightest  touch.  These 
excrescences  are  commonly  called  "  grapes,"  and  they  belong  to 
a  class  of  skin  diseases  described  by  dermatologists  as  "  acne," 
or  chronic  inflammation  of  the  sebiparous  glands,  characterised 
by  the  eruption  of  hard,  conical,  and  isolated  elevations,  which 
sometimes  suppurate  on  their  summits,  or  pour  forth  an  in- 
ordinate quantity  of  secretion ;  whilst  in  other  cases  their  action 
is  torpid,  the  sebaceous  matter  is  concreted  into  a  solid  form, 
and  distends  the  excretory  duct  and  hair  follicle  even  to  the 


672 


DISEASES  OF  THE  SKIN. 


orifice.  Professor  Hering  has  found  in  chronic  grease  large 
numbers  of  acari,  called  sarcoptes  Mppopodus,  of  which  the 
accompanying  woodcut  (Fig.  116)  is  an  illustration. 

Hering  says  of  it  that  its  body  is  twice  as  long  as  broad, 
beset  all  over  with  hairs  like  satin ;  head  retractile  ;  proboscis 
consisting  of  two  valves  moving  laterally  ;  mouth  directed  rather 
downwards ;  close  to  it  two  small  palpi ;  eight  feet,  five-jointed, 

the  last  joint  as  long  as  the  four 
preceding,  with  a  small  sucking  disc 
at  the  end,  and  two  small  hairs  on 
each  joint.  Two  pairs  of  feet  originate 
near  the  head,  and  two  posteriorly  on 
the  belly.  On  the  abdomen  a  small 
prominence,  and  four  long,  straight, 
plumose  bristles;  their  length  0'16, 
their  breadth  0'08— 0-085"'.  The 
three  pairs  of  bristles  on  the  back 
and  those  at  the  abdomen  can  be 
raised  like  the  tail  of  a  peacock.  The 
large  bristles  are  plumose  ;  the  hairs 
on  the  joints  of  the  feet  diminish  in 
length  towards  the  extremity  of  the 
foot.  Only  the  third  joint  of  the 
first  pair  of  feet  has  a  longer  hair. 

The  presence  of  this  parasite  in 
chronic  grease  is  accidental;  and 
other  diseases,  such  as  canker,  mal- 
lenders,  and  sallenders,  are  apt  to 
become  complicated  with  a  mange'  caused  by  this  parasite. 
Gerlach  designates  this  epizoon  symbiotes  equi,  and  says  that  the 
disease  induced  by  it  may  be  called  foot-mange;  but  it  has 
nothing  in  common  with  canker,  or  other  known  cutaneous 
eruption.  Attention  is  at  first  drawn  to  a  horse  with  this 
disease  by  his  rubbing  his  fore  legs,  or  striking  constantly  with 
the  hind  ones  during  the  night.  The  seat  of  the  disease,  and 
the  ready  detection  of  numerous  parasites  in  clusters  where  the 
crusts  or  scabs  form,  about  the  horse's  heels,  &c.,  suffice  to  enable 
us  to  diagnose  the  malady. 

The  swelling  of  the  legs  affected  with  grease,  at  first  consisting 
of  material  capable  of  reabsorption,   becomes  transformed,  in 


Fig.  116. — Sarcoptes  hippopo- 
dus. — (Hering.) 


ECZEMA  IMPETIGINODES.  673 

neglected  cases,  into  a  low  form  of  fibrous  tissue,  constitatini]: 
what  is  termed  elephantiasis ;  in  some  cases  the  affected  limbs 
become  enormously  enlarged  from  this  cause. 

The  causes  of  grease  are  both  intrinsic  and  extrinsic.  Of  the 
intrinsic  and  predisposing,  "  breed  "  is  the  most  common,  grease 
being  generally  met  with  in  hairy-legged  cart-horses  with  big 
broad  feet  and  light  "  washy  "  bodies.  Some  are  of  opinion  that 
white  legs  are  peculiarly  liable  to  this  disease ;  but  a  careful 
and  impartial  investigation  of  the  matter  has  led  me  to  conclude 
that  this  idea  involves  a  popular  fallacy. 

The  exciting  causes  of  grease  are,  improper  food,  especially 
moist,  inferior,  and  cooked  food,  clipping  the  hair  of  the  heels 
and  legs,  filth,  and  neglect. 

In  some  instances  the  best  bred  and  best  cared  for  horses  are 
liable  to  grease ;  but  in  them  it  scarcely  ever  assumes  a  chronic 
character,  but  partakes  more  of  an  erythematous  than  of  an 
eczematous  nature.  In  race-horses,  the  process  of  sweating 
induces  cracked  heels ;  the  sweat,  running  down  the  hollow  of 
the  heel,  dries,  and  leaves  the  part  impregnated  with  its  salts, 
which  act  as  irritants  to  the  skin. 


IMPETIGO  LABIALIS  ET  FACIALIS. 

The  disease  occurs  in  the  lower  animals  as  crusta  lahicdis, 
from  eating. some  kinds  of  food,  and  is  chiefly  seen  affecting 
animals  with  white  faces  and  legs.  Some  veterinarians  state 
that  it  is  unknown  to  attack  any  but  the  white  portion  of  the 
skin,  and  that  animals  without  white  hairs  are  exempt  from  the 
disease.  Professor  EoU,  of  Vienna,  refers  to  it  in  the  following 
terms : — There  occurs  amongst  horses  with  white  faces,  and  only 
at  pasture,  an  eruption  which  consists  in  small  pustules  over 
which  vellow  crusts  form,  and  which  adhere  to  the  rousjh  and 
thickened  skin.  An  ointment  is  required  to  favour  the  separa- 
tion of  the  scabs,  and  no  further  treatment  is  called  for. 

Mr.  Gamgee  mentions  several  other  authorities,  who  describe 
the  disease  as  occurring  upon  white  parts  of  the  body,  and  that 
its  origin  is  due  to  the  eating  of  vetches  which  had  become 
subject  to  honey-dew ;  buckwheat  in  flower  and  seed  ;  and  hot 
and  wet  weather,  after  animals  had  eaten  of  a  variety  of  wild 
polygonum ;   and  that  in  some  instances  the  white  portions  of 

2x 


674  DISEASES  OF  THE  SKIN. 

the  skin  inflamed  and  slouglied,  while  the  dark  parts  were 
unchanged.  This  peculiarity  can  scarcely  be  said  to  apply  to 
the  disease  as  it  manifests  itself  in  this  country,  where  colour 
or  the  want  of  it  does  not  affect  its  course  and  progress.  I  have 
repeatedly  seen  it  in  sheep,  as  well  as  in  cattle  and  horses,  fed 
on  certain  clovers,  which  seemed  to  excite  the  disease  more  by 
being  brought  into  contact  with  the  skin  than  by  any  effect  upon 
the  general  constitution ;  the  eruption  being  confined  to  those 
parts  of  the  body  which  were  continually  touched  by  the 
herbage,  namely,  the  lips,  nostrils,  coronets,  and  pasterns. 

Treatment. — The  removal  of  the  affected  animals  from  the 
field  containing  the  cause  will  generally  be  sufficient ;  but  should 
surgical  interference  be  required,  the  parts  are  to  be  rubbed  over 
with  the  zinc  or  lead  ointment,  and  purgatives  administered.  If 
there  be  much  pruritis,  the  irritable  parts  are  to  be  bathed  with 
the  following  lotion  : — 

^  Acid  Hydrocyanic,       .        .        .         §ss. 
Aqua,  .         .         .         .         .         |viii. 

and  afterwards  covered  over  with  lard. 

Mr.  Eobertson  of  Ellon  recommends  the  ointment  of  the 
nitrate  of  mercury. 


TREATMENT  OF  ECZEMATOUS  ERUPTIONS. 

The  different  forms  of  eczema  present  varieties  of  character 
peculiar  to  themselves,  and  these  must  be  borne  in  mind  when 
they  become  subject  to  the  veterinarian's  care.  In  most  instances, 
when  not  induced  by  direct  local  irritation,  the  eruption  may  be 
looked  upon  as  a  safety-valve  to  the  system,  and,  consequently, 
the  discharge  by  which  it  is  accompanied  must  be  suppressed 
very  gradually,  and  not  before  a  counter  one,  from  the  intestinal 
mucous  membrane,  has  been  medicinally  or  otherwise  estab- 
lished. 

In  all  cases  the  treatment  is  to  be  regulated  by  the  severity  of 
the  symptoms,  and  by  the  particular  cause  and  locality  of  the 
disease.  When  it  is  of  constitutional  origin,  purgatives  are  to 
be  employed,  which  are  to  be  succeeded  by  diuretics,  antacid 
stomachics,  and  when  the  disease  is  chronic,  specific  alteratives. 

Different  purgatives  are  used,  according  to  the  animal  treated : 
for  the  horse,  aloes  ;  for  horned  cattle,  sulphate  of  soda  or  mag- 


TREATMENT  OF  ECZEMATOUS  ERUPTIONS.  675 

nesia  ;  and  for  dogs,  jalap  and  calomel,  caster  oil,  or  the  syrup 
of  buckthorn.  The  diuretics  should  be  those  that  excite  the 
excretion  of  the  solid  constituents  of  the  urine,  such  as  colchi- 
cum,  with  the  nitrate  of  potash,  or  iodide  of  potassium.  When 
the  eczema  is  associated  with  disorder  of  the  digestive  apparatus, 
loss  of  appetite,  and  irregularity  of  the  bowels,  the  bicarbonate 
of  potass  or  soda,  and  bitters,  as  gentian,  quassia,  or  cinchona 
bark,  are  to  be  administered.  In  most  cases  of  irregularity  of 
the  bowels,  where  the  faeces  emit  a  foetid  and  peculiar  odour,  I 
have  found  two-ounce  doses  of  the  hypo-sulphite  of  soda  very 
useful.  Of  specific  alteratives,  arsenic,  in  the  form  of  arsenite 
of  potass,  is  the  most  valuable.  For  the  lower  animals  it  is  to 
be  prepared  in  the  simplest  manner  possible,  and  its  preparation 
is  as  follows: — Acid  arsen.,  5i. ;  potass  carb.,  3i. ;  aqua,  5xii. ; 
mix,  and  boil  slowly,  until  the  arsenic  is  dissolved,  and  strain 
when  cold.  Prepared  in  this  way,  it  is  almost  tasteless,  and 
quite  odourless.  Each  ounce  of  the  solution  contains  five  grains 
of  arsenic :  the  dose  is  from  half  an  ounce  to  an  ounce  of  the 
liquor,  two  or  three  times  a  day  for  the  horse,  mixed  with  his 
food  or  water ;  horned  cattle  will  take  rather  larger  doses ;  and 
the  dog,  thirty  to  sixty  drops,  according  to  size. 

For  animals  in  low  condition,  the  arsenic  may  be  combined 
^vith  vegetable  tonics,  and  given  in  the  form  of  a  ball,  nux 
vomica  making  a  valuable  combination  with  it. 

The  diet  is  to  be  regulated  according  to  each  particular  case. 
Some  animals  are  so  constituted  as  to  be  afiected  by  what  in 
others  proves  to  be  the  simplest  of  food,  namely,  green  food. 
In  such  instances,  there  must  be  a  change  to  dry  food,  and  in 
all,  duriDg  the  earlier  stages  of  the  disease,  there  must  be  some 
alteration  and  restriction  both  as  to  the  quantity  and  quality. 
It  must  also  be  borne  in  mind  that  all  rough  articles  of  diet, 
such  as  meal-seeds,  coarse  straw,  and  other  inferior  and  damaged 
stuffs,  are  very  prone  to  cause  skin  diseases.  Locally,  the  parts 
affected  are  to  be  bathed  with  warm  water,  or  poulticed,  if  pos- 
sible. The  irritation  and  itchiness  (pruritis)  are  relieved  by  the 
application  of  a  diluted  solution  of  the  diacetate  of  lead,  the 
white  lotion,  or  a  solution  of  the  carbonate  of  potash ;  in  cases 
where  the  itching  is  very  extreme,  by  hydrocyanic  acid  largely 
.  diluted.  When  in  this  state  of  itchiness,  the  animal  should  be 
fastened,  so  as  to  prevent  his  biting  or  otherwise  damaging  him- 


676  DISEASES  OF  THE  SKIN. 

self.  To  the  parts  that  have  already  been  made  raw,  a  mixture 
of  acetate  of  lead  and  olive  oil  may  be  applied  with  advantage. 

The  local  applications  to  the  impetiginous  form  of  eczema 
differ  somewhat  from  the  above,  and  consist  of  fomentations 
and  poultices,  succeeded  by  mild,  and  afterwards  by  strong, 
astringents. 

A  very  useful  application  to  greasy  and  cracked  heels  is 
found  in  the  oxide  of  zinc  ointment.  The  benzoated  oxide  of 
zinc  ointment  is  recommended  by  Erasmus  Wilson  as  the 
most  perfect  local  application  for  all  chronic  inflammations  of 
the  skin. 

Professor  Dick,  who  was  very  successful  in  the  treatment  of 
grease,  recommends  that  the  legs  should,  in  the  early  stages,  be 
washed  twice  a  day  with  soap  and  water,  and  a  solution  of 
sugar  of  lead  and  sulphate  of  zinc  applied.  "  This,"  says  the 
Professor,  "  may  not  be  chemically  scientific,  but  I  have  found 
it  superior  to  anything  else.  When  grapes  abound,  powdered 
sulpliate  of  zinc  should  be  introduced  among  them,  which  is 
found  often  to  supersede  the  application  of  the  actual  or  other 
cauteries ;  and,  in  like  manner,  strong  washes  with  diluted 
sulphuric  and  nitric  acids  prove  not  less  efficient." 

I  have  found  it  necessary  in  many  cases  to  remove  the  grapes 
with  the  actual  cautery,  more  especially  when  very  numerous  ; 
and  for  this  purpose  two  blacksmiths'  fire-shovels  are  the  best 
instruments ;  one  to  be  made  sharp  at  its  edge,  and  heated 
to  a  red  heat,  to  remove  the  excrescences  ;  the  other  kept  cold, 
and  placed  between  the  skin  and  hot  shovel,  to  prevent  undue 
burning.  In  this  manner  I  have  removed  many  scores  of  these 
excrescences  in  a  few  minutes ;  whereas,  if  they  had  been 
destroyed  by  caustics,  such  as  the  sulphate  of  zinc,  corrosive 
sublimate,  or  the  strong  acids,  the  destruction  must  have 
been  effected  by  slow  degrees,  or  deep  and  extensive  slough- 
ino-s  of  the  skin  and  subcutaneous  tissues  would  have  occurred. 

to 

"When,  however,  the  grapes  are  few  in  number,  their  points 
may  be  carefully  dressed  with  the  sulphate  of  zinc  or  cor- 
rosive sublimate,  care  being  taken  that  the  applications  be  not 
too  extensive. 

The  foetor  of  the  discharge  of  grease,  either  in  its  acute  or 
chronic  form,  is  much  modified  by  carbolic  acid.  In  the  acute 
stage,  a  Little  of  the  pure  acid  is  to  be  added  to  the  lead  or  zinc 


TEEATMENT  OF  ECZEMATOUS  ERUPTIONS.         677 

lotion  ;  while  in  tlie  chronic,  the  crude  acid  may  be  applied,  for  one 
dressing,  undiluted.  In  this  form  it  stimulates  the  skin  to  healthy 
action ;  but  when  applied  after  the  first  time,  it  must  be  diluted 
with  oil  or  glycerine,  one  to  twenty  parts,  or  inflammation  and 
sloughing  will  be  induced.  As  primary  applications,  even  in 
the  treatment  of  chronic  grease,  poultices  are  very  useful ;  they 
clean  the  parts,  soften  and  remove  scabs,  and  allay  the  inflam- 
mation of  the  skin  ;  boiled  turnips  are  best,  and  they  may  con- 
tain yeast,  charcoal,  carbolic  acid,  or  the  hypo-sulphite  of  soda, 
as  deodorisers. 

In  chronic  grease,  after  the  bowels  have  been  well  opened  by 
a  cathartic,  arsenic  and  diuretics  are  to  be  prescribed  until  the 
anasarcous  swellings  disappear ;  and  should  there  be  a  disposi- 
tion to  a  return  of  the  disease,  the  arsenic  is  to  be  continued,  and 
combined  with  tonics. 

When  it  is  deemed  necessary  to  change  the  arsenic  for 
another  remedy,  the  sulphates  of  iron  and  copper  may  be  sub- 
stituted. 

Chronic  eczema,  when  expressed  by  an  eruption  other  than 
that  of  grease,  requires  a  speciality  of  treatment  applicable  to 
itself. 

1st.  The  crusts  and  scabs,  after  being  soaked  with  oil  for  a  few 
hours,  are  to  be  removed  by  washing ;  if  the  hair  is  long  it  must 
be  clipped,  and  this  applies  to  the  greasy  as  well  as  to  the  other 
forms  of  eczema.  When  the  hair  is  removed  and  the  parts 
thoroughly  cleaned,  a  sufficiency  of  the  following  may  be  appHed, 
not  only  to  the  diseased,  but  to  a  good  deal  of  healthy  skin ; 
remembering  that  whatever  the  remedy  may  be,  much  depends 
upon  its  effectual  application : — 

Ijc  Sulphur  sublimata,         .         .         .         §viii. 
Potass  carbonatis,  . 
Acid  carbolicum,    . 
Adipis,  . 
01.  Olivie,      . 

This  is  to  be  left  on  the  skin  for  two  or  three  days,  and  then 
washed  off  with  soft  soap  and  warm  water.  It  acts  as  a 
cutaneous  stimulant. 

The  other  remedies  available  in  chronic  eczema  are  lime 
water,   bichloride   of  mercury  in  weak  solution,  tar  ointment. 


5 IV. 
gi. 

§xxxii. 
|xxxii. 


678  DISEASES  OF  THE  SKIN. 

and  mercurial  ointment;  and  to  relieve  the  itcliing  (pruritis), 
when  it  is  very  great,  hydrocyanic  acid  lotion. 

Canine  skin  diseases  require  to  be  treated  with  very  great 
care ;  remedies  that  cause  a  great  amount  of  constitutional  dis- 
turbance in  the  dog  have  no  such  effect  when  applied  to  other 
animals  :  for  example,  carbolic  acid,  although  carefully  prepared 
and  diluted,  and  as  carefully  applied,  produces  in  some  instances 
so  much  depression  as  to  cause  death  in  a  few  hours,  by  a 
gradual  failure  of  the  heart's  action  (asthenia)  ;  in  others,  where 
the  first  depressing  effects  of  the  remedy  have  been  overcome  by 
stimulants,  warmth,  or  electricity,  the  animal  has  fallen  into  a 
state  of  marasmus,  with  sunken  eyes,  foetor  of  the  breath,  forma- 
tion of  sordes  on  the  teeth,  "  tarry"  fseces,  total  loss  of  appetite, 
and  death  in  six  to  twelve  days.  For  these  reasons  I  have 
discontinued  the  carbolic  acid  in  dog  cases,  although  it  is  an 
excellent  local  remedy.  It  might  be  supposed  that  these  toxic 
effects  result  from  the  dog  licking  himself,  thus  introducing  the 
acid  into  the  stomach.  I  held  this  opinion  at  first,  but  further 
observation  of  cases  where  such  precautions  were  taken  as  to 
render  the  licking  of  the  poison  an  impossibility,  has  con- 
vinced me  that  it  is  absorbed  into  the  system  through  the  skin  ; 
that  it  has  a  peculiar  effect  upon  the  dog,  and,  consequently,  is 
a  dangerous  remedy.  For  similar  reasons  the  mercurial  oint- 
ment is  unsafe. 

For  the  dog  the  following  is  the  safest  and  best  cutaneous 
stimulant : — 

5-  Unguentum  sulpho-alkalinum. 

Sulph.  sublim.  ....  3i. 

Potass,  carb.      .  .  .  ,  Z\. 

Adipis,  ,  .  .  •  ?i. 


CHAPTER  XXXIX. 

DISEASES  OF  THE  SKIN — COUtmiied, 

SQUAMOUS    INFLAMMATION    OF    THE    SKIN PSORIASIS — PITYRIASIS — 

DISORDERED  SENSIBILITY  OF  THE  DERMA PRURIGO INFLAMMA- 
TION OF  THE  SEBACEOUS  FOLLICLES — ACNE — SITFASTS — TREAT- 
MENT. 

SQUAMOUS  INFLAMMATION  OF  THE  SKIN, 

Diseases  cliaracterised  by  inflammation  and  hypertrophy  of  the 
derma,  and  the  production  on  the  diseased  skin  of  laminse  or 
scales.  Of  tliis  disease  we  have  two  examples,  namely,  psoriasis 
or  dry  tetter,  and  pityriasis. 

PSORIASIS, 

"A  chronic  and  non-contagious  inflammation  of  the  derma, 
characterised  by  the  development  of  patches,  which  are  irregular 
in  form  and  size,  and  covered  by  irregular  scales  of  epithelium. 
The  patches  are  raised  above  the  level  of  the  surrounding  skin ; 
they  are  flat  upon  the  surface,  or  somewhat  more  elevated  in  the 
centre  than  at  the  circumference,  and  are  frequently  intersected 
by  deep  fissures  and  chaps,  particularly  where  the  disease  occupies 
a  surface  of  large  extent." — (Wilson.) 

In  the  horse  we  have  familiar  examples  of  the  above  in  what 
have  been  already  mentioned,  namely,  psoriasis  carpi  et  tarsi,  or 
mallenders  and  sallenders.  At  first  mallenders  and  sallenders 
are  generally  due  to  an  eczematous  eruption,  but  as  they  become 
chronic,  the  discharge  with  which  they  are  attended  in  the  earlier 
stages  ceases  to  flow,  and  the  disease  is  characterised  by  the 
formation  of  scales. 

Psoriasis   is   usually    met   with   in  horses   otherwise    quite 


680  DISEASES  OF  THE  SKIN". 

healthy,  and  it  is  essentially  a  chronic  and  often  an  intract- 
able disease;  but  it  never  spreads  over  any  great  extent  of 
surface,  being  generally  confined  to  the  flexures  of  the  limbs. 

I  have  reason  to  think  that,  like  lymphangitis,  grease,  and 
anasarcous  swellings  of  the  legs,  it  is  often  of  hereditary  origin. 

The  scaly  eruptions  of  psoriasis  are  unsightly,  lower  the  value 
of  an  animal,  and  are  occasionally  troublesome,  crack,  inflame, 
and  discharge  a  bloody  serosity. 

Treatment. — Generally  remedies  seem  to  have  no  effect,  and 
beyond  modifying  the  condition  of  the  cracks  when  inflamed, 
the  efforts  of  the  practitioner  are  productive  of  no  positive 
results. 

To  prevent  the  formation  of  the  cracks  and  chasms,  the  scales 
should  be  dressed  occasionally  with  some  oily  material;  and 
when  they  become  much  thickened  by  accumulation,  they  are  to 
be  well  soaked  in  an  alkaline  solution,  carefully  washed  off,  and 
the  raw  skin,  thus  exposed,  touched  with  the  nitrate  of  silver. 
An  occasional  application  of  the  unguentum  hydrargjTum  is  also 
useful. 

In  the  case  of  a  valuable  animal,  where  the  eradication  of  the 
disease  is  a  question  of  importance,  the  treatment  must  be  both 
local  and  general. 

The  general  treatment  comprises  a  purgative,  followed  by 
arsenic  and  cantharides,  either  separately  or  in  combination — 
the  iodide  of  arsenic,  or  by  a  triple  compound  of  arsenic,  iodine, 
and  mercury,  which  may  also  with  advantage  be  employed  as  a 
local  remedy ;  it  is  made  as  follows  : — 

B^  Liquor  hydriodatis  arsenici  et  hydrargyri :  triturate  of  finely 
levigated  metallic  arsenic,  6'08  grains ;  mercury,  15"38  grains ; 
and  iodine,  50  grains,  with  1  drachm  of  alcohol,  until  the  mass 
be  dry,  and  changed  in  its  colour  from  a  deep  brown  to  a  pale 
red.  Next  triturate  the  mass  for  a  few  moments  with  eicjht 
ounces  of  distilled  water ;  transfer  the  solution  to  a  bottle,  add 
to  it  haK  a  drachm  of  hydriodic  acid,  and  filter,  making  up  to 
eight  ounces  by  means  of  distilled  water  if  there  is  any  defi- 
ciency. The  solution  is  of  a  golden  yellow  colour,  and  each 
drachm  contains — water,  1  drachm ;  protoxide  of  arsenic,  i 
grain ;  protoxide  of  mercury,  ^  grain ;  iodine  converted  into 
hydriodic  acid,  ^  grain.  The  dose  of  this  for  the  horse  is  from 
two  to  three  ounces  twice  a  day,  care  being  taken  that  its  effects 


PSORIASIS.  681 

are  not  pushed  too  far.  When  arsenic  or  its  combinations  can 
no  longer  be  tolerated,  the  tincture  of  cantharides  may  be  tried ; 
and  lastly,  should  these  prove  ineffectual,  sulphuric  acid  may 
be  internally  administered.  Of  all  local  applications  tar  oint- 
ment is  the  best. 


PITYRIASIS, 

A  name  derived  from  the  Greek  word  Trlrvpa,  "bran,  and  given 
to  a  morbid  condition  of  the  skin,  characterised  by  the  rapid 
production  of  numerous  fine  white  scales,  with  no  exudation  into 
the  derma,  and  no  albuminous  secretion  on  the  surface. 

This  is  a  very  common  disease  among  horned  cattle,  particu- 
larly young  stock,  and  affects  various  parts  of  the  body,  the  neck 
and  shoulders,  the  rump,  sides,  &c.  It  is  accompanied  by  some 
degTce  of  itchiness,  and  the  scurf  often  furnishes  a  habitat  for 
the  production  and  development  of  vermin. 

The  development  of  pityriasis  seems  to  be  due  to  an  ill-fur- 
nished condition  of  the  animal  body,  arising  from  poor  food, 
and  it  generally  prevails  in  the  winter  and  early  spring  months, 
and  disappears  spontaneously  when  the  cattle  are  put  into  good 
pastures. 

The  treatment  must  consist  of  good  food,  the  alleviation  of 
the  itchiness,  and  the  destruction  of  the  vermin  which  become 
associated  with  it,  by  sulphur  ointment  or  an  ointment  of  staves- 
acre.  If  the  disease  attack  an  extensive  surface,  the  sulphur  is 
the  safer  remedy,  as  the  animals  lick  their  skins,  and  may  take 
more  stavesacre  into  their  stomachs  than  is  good  for  them. 

Pityriasis  in  the  horse  is  due  to  a  condition  of  the  system 
associated  with  the  presence  of  the  oxalate  of  lime  in  the  urine. 

The  pathological  relations  of  the  oxalates,  and  the  conditions 
conducive  to  their  formation,  are  not  intended  for  discussion  at 
present;  but  I  may  point  out  that  the  bran-like  scurf,  found 
on  the  coats  of  horses  in  every  way  carefully  attended  to  and 
groomed,  is  associated  with  a  degree  of  indigestion,  frequent 
urination,  more  or  less  loss  of  condition,  debility,  harshness  and 
dryness  of  the  skin,  and  "  hide-bound ;"  and  that  most  frequently 
the  disease  is  found  to  affect  animals  which  are  irregularly 
worked  but  otherwise  well  treated. 

Some  kinds  of  food,  such  as  carrots  and  turnips,  favour  the 


682  DISEASES  OF  THE  SKIN. 

development  of  oxalic  acid  in  the  circulation ;  and  on  this 
account  they  must  not  be  given  in  cases  of  pityriasis. 

In  some  instances  this  bran-like  scurf  seems  to  be  due  to  a 
deficient  secretion  of  the  sebaceous  follicles  of  the  legs  and  heels, 
induced  by  the  use  of  soft  soap  or  very  hard  water ;  however,  it 
is  not  correctly  pityriasis,  but  erythema,  accompanied  with  fine 
branny  scales. 

Scales  also  form  on  various  parts  of  the  body,  caused  by  con- 
tact with  ill-fitting  harness ;  but  this  is  not  properly  pityriasis, 
but  desquamation  of  cuticle  owing  to  irritation. 

Pityriasis  is  distinguished  from  psoriasis  by  the  absence  of 
tliickening  of  the  derma,  by  the  scales  being  finer,  separating 
more  easily,  by  their  very  rapid  production,  and  by  the  disease 
not  attacking  the  flexures  of  the  limbs. 

Treatment. — The  treatment  is  to  be  general,  and  to  consist 
in  the  prohibition  of  all  articles  of  diet  calculated  to  furnish 
much  saccharine  matter.  A  gentle  purgative  is  to  be  adminis- 
tered, succeeded  b}"  the  persistent  use  of  pitch  internally.  The 
pitch  seems  to  have  some  influence  in  preventing  the  conversion 
of  the  starchy  and  saccharine  constituents  of  the  food  into 
oxalic  acid. 

Liquid  pitch  made  into  a  ball  of  sufficient  size,  with  linseed 
meal,  answers  the  purpose  very  well,  the  dose  being  regulated 
by  the  size  of  the  horse. 

Alkahne  lotions  may  be  applied  to  the  skin  if  the  scurf  is  at 
all  thick  ;  but,  as  a  rule,  the  scales  speedily  separate  from  the 
skin,  collect  on  the  surface  of  the  hair,  and  are  easily  removed 
with  the  brush. 


DISOEDERED  SENSIBILITY  OF  THE  DERMA. — PRURIGO. 

Prurigo  or  Pruritis. — The  most  striking  feature  of  this  con- 
dition is  severe  itching,  and  it  very  often  consists  of  what  Mr. 
Percivall  calls  "  a  sort  of  cutaneous  furoi\  to  which  horses,  pam- 
j)ered  and  little  worked,  are  liable,  and  which  appears  constitu- 
tional in  its  origin." 

There  is  insufferable  itching,  and  the  habit,  once  contracted, 
is  exceedingly  difficult  to  get  rid  of. 

Cases  of  this  kind  must  be  treated  by  purgatives,  alkalies,  and 
alkaline  washes,  such  as  the  following : — 


PRUEIGO.  683 

]J:  Potass  liquoris,         .         .         51!. 

Hydrocyanic  acidi,  .         ,  5!. 

Aqua,       ....         Oii. 
Mix,  and  apply  to  all  the  irritated  parts  of  the  skin. 

Pruritis  of  the  tail  is  a  very  common  form  of  the  disease,  and 
seems  to  become  a  habit  with  some  horses.  Sometimes,  how- 
ever, it  depends  upon  the  presence  of  ascarides  in  the  rectum. 
The  treatment  consists  in  giving  enemas  of  a  decoction  of  quassia 
to  destroy  the  parasites,  dressing  the  tail  with  mercurial  oint- 
ment, or  with  equal  parts  of  paraffin  and  fish  oil,  and  if  the 
disease  affects  the  skin  generally,  give  twice  daily,  flour  sulph. 
3ij.,  arsenicum  gr.  ij.,  mixed  with  the  food;  and  when  the 
prurigo  is  a  habit,  the  root  of  the  tail  must  be  protected  by 
a  strong  leather  band,  securely  fastened  whilst  the  animal  is  in 
the  stable.  ^ 

ACXE 

Affects  the  sebaceous  follicles  of  the  skin  generally,  and  appears 
as  pimples,  commonly  known  as  warbles  or  grubs  in  the  skin. 
The  parts  most  frequently  affected  are  the  withers,  back,  and 
neck,  and  more  particularly  the  "  root  of  the  mane."  The 
eruption  of  acne  begins  as  an  elevation  of  variable  size,  the 
summit  of  which  suppurates,  and  remains  for  several  days  as  a 
pustule  with  an  indurated  base,  leaving  a  swelling,  which  slowly 
disappears.  The  disease  is  very  prevalent  in  the  spring,  some- 
times affecting  the  tail  as  well  as  the  mane  and  neck.  When 
situated  in  parts  which  are  liable  to  be  chafed  by  the  harness, 
these  pustules  are  very  troublesome,  often  rendering  it  necessary 
to  throw  the  animal  off  work  until  they  are  quite  healed. 

Harness  lined  mth  thick,  coarse  woollen  cloth,  is  a  cause  of 
this,  as  well  as  other  skin  diseases  ;  and  it  may  be  mentioned  here 
that  all  harness  ought  to  be  lined  with  light  smooth  leather. 

The  Treatment. — If  the  pimples  are  hard,  and  suppurate  slowly, 
poultices  nicely  applied  are  very  useful ;  but  w^hen  inapplicable, 
fomentations  are  to  be  employed,  and  the  parts  dressed  with 
the  lead  or  zinc  lotion.  The  general  treatment  is  to  be  directed 
to  the  removal  of  all  constitutional  causes  of  derangement,  and 

^  For  circumscribed  itchings,  the  mercxirial  ointment  is  perhaps  the  best  remedy 
that  can  be  applied  ;  but  when  the  disordered  surface  is  extensive,  it  is  dangerous 
to  use  it,  and  it  must  give  way  to  a  more  harmless  remedy. 


684  DISEASES  OF  THE  SKIN. 

this  is  best  effected  by  purgatives,  diuretics,  and  stomachics. 
Sulphur,  internally  administered,  is  also  very  useful,  stimulat- 
ing the  cutaneous  glands,  and  assisting  the  process  of  "  casting 
the  coat ;"  a  process  with  which  these  eruptions  seem  to  have  a 
close  affinity. 

If  the  tumours  become  indolent,  they  require  stimulation  with 
iodine  or  the  iodide  of  mercury. 

Occasionally  the  pressure  of  the  harness  upon  these  eleva- 
tions produces  a  circumscribed  form  of  gangrene  of  the  skin, 
surrounded  by  a  red  circle  of  inflammatory  congestion  and  sup- 
puration. After  a  time,  the  gangrenous  skin  assumes  a  hard, 
horny,  or  leathery  appearance,  adheres  firmly  to  the  subcutaneous 
tissue,  is  surrounded  by  an  angry-looking  suppurating  wound, 
and  from  the  difficulty  experienced  in  its  removal,  the  white 
gangrenous  patch  has  been  called  a  "  sitfast." 

These  sitfasts  are  also  seen  to  arise  independently  of  any  pre- 
vious pimple,  and  are  caused  by  the  pressure  of  badly  fitting  harness. 

The  centre  of  the  sitfast  seems  to  retain  some  portion  of  its 
vitality,  and  from  its  connection  with  the  more  perfectly  living 
tissue  being  to  a  degree  retained,  it  is  not  thrown  off  spon- 
taneously, as  in  the  case  of  a  more  completely  gangrenous 
patch.  The  circumference  of  the  patch  dries,  shrivels  up,  and 
irritates  the  surrounding  living  tissues,  which  suppurate  more 
or  less  abundantly. 

Treatment. — Bemoval  of  the  leathery  patch  by  carefully 
dissecting  it  out  is  the  only  expeditious  method  of  treatment, 
the  wound,  so  made,  to  be  afterwards  treated  in  the  usual 
way.  Some  writers  recommend  blisters  and  caustics,  but 
they  are  quite  inapplicable,  and  the  only  circumstance  that 
admits  of  the  use  of  a  caustic,  is  where  a  thin  pellicle  of  the 
degraded  material  is  not  removed  with  the  knife.  In  such  a 
case  the  nitrate  of  silver,  carefully  applied,  is  a  useful  remedy. 

For  an  account  of  cutaneous  new  formations,  the  reader  is 
referred  to  the  chapters  on  Tumoues. 

Purimra  hcemorrhagicay  scarlatina  j  variola,  and  other 
affections  which  have  hitherto  been  described  as  diseases  of  the 
skin,  are  mere  symptoms  of  grave  pathological  conditions  of  the 
body,  dependent  on  an  alteration  of  the  fluids  belonging  to  a 
class  of  blood  diseases,  which  I  hope  to  describe  at  some  future 
period. 


CHAPTER  XL. 

DISEASES  OF  THE  SKIN — continued. 

SCABIES — DIFFERENT   VARIETIES    OF    ACARI SARCOPTES — DERMATO- 

DECTES — SYMBIOTES CLASSIFICATION EXPERIMENTS  OF  HERING, 

HERTWIG,    AND    OTHERS    AS    TO    THE    TRANSMISSIBILITY    OF    THE 

MITES  TO  MAN MANGE    IN    THE  HORSE  AND  OX SCAB  IN  SHEEP 

MANGE     IN     THE    DOG    AND    CAT TREATMENT     OF     MANGE 

DISEASES    DUE    TO   EPIZOA POULTRY   LOUSINESS — FLEAS — TICKS 

— BOTS — MAGGOTS. 

PARASITIC  DISEASES  OF  THE  SKIN". 

This  order  of  skin  diseases  may  be  considered  under  two 
heads : — (1.)  Diseases  due  to  the  presence  of  parasites  from  the 
animal  kingdom  (dermatozoa) ;  and  (2.)  those  due  to  parasites 
from  the  vegetable  kingdom  (dermatophyta). 

I.  DISEASES  DUE  TO  ANIMAL  PARASITES. 
SCABIES. 

Scabies,  mange,  itch,  or  scab,  is  a  contagious  skin  disease, 
due  to  the  presence  of  animal  parasites  belonging  to  the  class 
arachnida,  the  order  acarida,  or  mites ;  sub-order,  crawling 
mites;  family,  sar copies,  of  which  there  are,  according  to  Gerlach, 
three  genera  : — a,  sarcoptes,  that  burrow  in  the  skin;  h,  dermato- 
dectes,  that  simply  bite  and  hold  on  to  the  skin;  and  c,  symbiotes, 
living  together  in  large  numbers,  and  piercing  no  farther  than 
the  epidermis  in  search  of  food. 

All  these  parasites  live  on  serosity,  the  effusion  of  which  is 
caused  by  the  irritation  which  they  excite. 


686  DISEASES  OF  THE  SKIN". 

Mr.  Gamgee,  translating  from  Gerlacli,  gives  the  following 
arrangement  of  the  species  belonging  to  each  genus  : — 

A*  Sarcoptes.  B.  Dermatodectes.       O.  Symhiotes. 

1.  S.  hominis.  1.  D.  equi.  1.  S.  equi 

2.  S.  equi  2.  D.  bovis.  2.  S.  bovis. 

3.  S.  suis.  3.  D.  ovis.  3.  S.  elephantis. 

4.  S.  cards. 

5.  S.  catis. 

6.  S.  caniculi. 

To  the  genus  sarcoptes  belong  also : — 

S.  rupicaprae. — (Hering.) 
S.  dromedarii. — (Gervais.) 

The  experiments  of  Hering,  Hertwig,  and  others  have  proved 
that  the  mange  insect  may  be  transferred  from  the  lower  animals 
to  man ;  that  they  bore  the  human  skin,  erect  galleries  in  it, 
and  cause  itch-like  eruptions.  In  general,  however,  the  erup- 
tions last  only  as  long  as  the  individual  life  of  the  mites  trans- 
ferred. Upon  this  point  observations  vary,  some  extending  the 
continuance  of  the  eruption  to  a  period  of  six  weeks,  whilst 
others  limit  it  to  two  or  three.  All  are,  however,  agreed  that 
they  do  not  procreate  in  the  human  skin ;  that,  although  those 
in  attendance  on  mangy  horses  may  suffer  from  the  disease,  they 
do  so  only  very  slightly,  and  but  for  a  limited  period. 

SAECOPTES  HOMINIS  (ACARUS  SCABIE). 

"  The  male  is  about  one-third  smaller  than  the  female.  He 
has  suckers  on  two  hind  feet,  and  possesses  on  the  abdominal 
surface  genital  organs,  all  of  which  characters  are  absent  in  the 
female.  She,  on  the  other  hand,  in  addition  to  her  size,  and  the 
negative  marks  alluded  to,  is  characterised  by  three  kinds  of 
horny  spines,  which  are  scattered  over  her  back.  The  suckers, 
or  ambulacria,  are  organs  of  locomotion ;  the  mandibles  enable 
it  to  cut  the  epidermis,  and  extract  fluid  from  the  tissues,  which 
passes  through  a  delicate  oesophagus,  the  termination  of  which 
is  undermined;  the  body  of  the  animal  being  filled  with  an 
unorganized,  very  fine  molecular  pulp.  A  short,  delicate  tube 
may  also  sometimes  be  observed  at  the  anus — a  supposed 
rectum.     Ko  respiratory  apparatus  can  be  discovered,  although 


SCABIES. 


687 


the  creature  may  be  seen  to  swallow  minute  bubbles  of  air, 
which  pass  down  the  c^sophagus,  and,  like  the  nutritive  juices, 
diffuse  themselves  through  the  interior.  At  all  events,  animal 
juice  and  air  are  both  necessary  to  the  life  of  the  acarus." — 

(BOURGUIGNON.j 


Tig.  119. 


Fig.  117 — Dorsal  surface  of  the  female  acanis  scabie. 

Fig.  118.— Ventral     ,,  ,,  ,,  ,, 

Fig.  119, — Ventral  surface  of  the  male  acarus.— (Bourguignon.) 


100  diam. 


It  is  the  female  only  which  burrows  in  the  epidermis  of  the 
human  skin.  All  the  male  acari  go  free  on  the  surface  of  the 
epidermis,  where  sexual  intercourse  between  male  and  female  is 
said  to  take  place.  Wlien  an  impregnated  female  is  placed  on 
the  surface  of  the  skin,  it  seeks  a  suitable  spot  to  penetrate,  and 
raising  its  head  at  right  angles  to  the  surface,  it  burrows,  digs, 
or  eats  its  way  between  the  scales  into  the  deeper  layers  of  the 
epidermis,  where  it  imbeds  itself,  derives  nourishment,  and  goes 
through  the  process  of  parturition,  till  it  dies.  Having  found  a 
suitable  place,  an  egg  is  laid,  and  each  day  another,  the  animal 


688 


DISEASES  OF  THE  SKIN. 


penetrating  a  little  farther  each  time,  leaving  its  deposited  eggs 
to  occupy  the  space  previously  inhabited  by  itself.  The  direc- 
tion of  the  canal  is  oblique,  the  portion  firet  formed  being,  of 
course,  nearest  the  surface.  As  the  old  epidermis  is  thrown  off, 
new  layers  of  cuticle  being  formed  from  the  deeper  strata,  the 
first-laid  eggs  are  gradually  thrust  upwards  to  the  surface,  where 
they  are  finally  extruded ;  while  the  recently  deposited  ova 
remain  in  the  canal,  close  to  the  parent  female,  whose  instincts 
lead  her  to  make  the  canal  in  such  a  way  that  her  eggs  reach 
the  surface  about  the  time  the  young  ones  are  ready  to  come 
out  of  the  shell.  The  newly  hatched  acari,  male  and  female, 
crawl  about  the  skin,  and  are  said  to  moult  their  skins  three 
times  before  they  reach  maturity;  this  occupies  nearly  five 
weeks.  They  then  enter  into  sexual  intercourse;  the  female 
burrows  the  skin,  as  before  described,  and  dies  at  the  blind  end 
of  the  canal  or  caniculus,  after  depositing  her  ova ;  whilst  the 
male  rambles  about  on  the  surface,  entering  into  sexual  inter- 
course wdtli  many  females,  a  proof  of  the  necessity  for  fewer 
males  than  females. 

Authors  differ  as  to  the 
time  required  for  incuba- 
tion ;  some  say  that  egg- 
hatching  occurs  in  eight  or 
ten  days ;  whilst  Gerlach 
brings  forward  experiments 
to  prove  that  three  days  are 
sufficient  for  this  purpose. 

SARCOPTES  EQUI. 

The  males  of  this  pretty 
large  species,  which  is  visible 
to  the  naked  eye,  are  about 
yV"  in  length  and  breadth, 
resembling  a  square  notched 
at  its  four  angles;   arched 
on  its  back  and  belly,  and      Fig.  120.— Sarcoptesequi.— (Gerlach.) 
tolerably  thick;  the  body  covered  with  alternate  furrows  and 
varied  lines,  running  transversely  on  the  back  and  abdomen 
in  a  semicircular  form.     On  the  back  there  are  small  tubercles. 


SCABIES.  689 

and  towards  the  front,  long  stiff  hairs.  The  females,  which 
are  far  more  abundant,  only  differ  from  the  males  in 
their  size,  being  about  one- third  longer,  and  in  the  struc- 
ture of  the  two  posterior  pairs  of  feet,  which  are  attached 
to  the  belly,  close  together,  of  equal  length  and  strength,  but 
shorter  and  weaker  than  in  the  male.  The  external  (third) 
pair  of  feet  has  two  long  terminal  hairs,  but  no  sucking  disc. 
The  internal  (fourth)  pair  has  the  rudiments  of  a  claw,  a  sucking 
disc,  and  a  fine  terminal  hair  at  the  base  of  the  stalk  of  the 
sucking  disc.  The  colour  of  the  parasite  is  whitish ;  the  horny 
skeleton  reddish-brown — ferruginous.  The  eggs  are  very  large, 
coated  with  a  sticky  mass,  and  are  often  carried  about  by  the 
female  between  her  legs.  The  eggs  are  deposited  in  small 
galleries  under  the  epidermis.  The  young  are  very  small,  but 
grow  very  quickly  during  the  first  four  days ;  and,  according  to 
Hertwig,  have  their  eight  feet  at  once,  but  only  six  according 
to  Hering.  Their  movements  are  effected  quickly,  and  by 
means  of  the  feet  provided  with  sucking  discs.  They  may  be 
kept  alive  for  three  weeks  without  nourishment.  Wherever 
they  penetrate  the  skin,  a  small  knotted  elevation  is  produced, 
with  a  small  passage,  at  the  extremity  of  which  the  acarus  sits. 
The  epidermis  becomes  soft,  separates  from  the  true  skin,  and 
an  exudate  is  thrown  out,  which,  along  with  the  epidermis, 
dries  into  scaly  scurfs,  that  become  detached. 

The  transference  of  this  acarus  from  the  horse  to  man  has 
been  proved  by  many  observers — for  example,  E.  Viborg,  Sydow, 
Osiander,  Greve,  Groguier,  and  Hertwig — as  well  as  the  trans- 
ference of  the  disease  so  caused  from  one  man  to  another; 
but  the  mites  do  not  propagate  on  the  human  skin,  and  the 
symptoms  of  their  presence  spontaneously  disappear  about  the 
twelfth  day. 

The  sarcoptes  equi  is  transmissible  to  horned  cattle ;  but  it 
is  as  yet  doubtful  if  the  dog,  cat,  and  pig  are  susceptible  of 
the  mange  induced  by  it.  Gerlach  failed  to  communicate  the 
disorder  to  the  sheep,  although  the  mites  were  by  him  placed 
on  the  skin. 

THE  DERMATODECTES  EQUI. 

The  dermatodectes  equi,  which  has  hitherto  been  looked 
upon  as  the  veritable  sarcoptes  or  acarus  equi,  does  not  live, 

2y 


690 


DISEASES  OF  THE  SKIN. 


like  the  latter,  on  the  skin  of  other  creatures  besides  the  horse. 
Its  existence  is  short,  if  conveyed  to  the  skin  of  man,  or  of  an 
ox,  sheep,  dog,  &c.,  and  the  form  of  horse  mange  which  it 
induces  is,  therefore,  essentially  confined  to  the  equine  species ; 
and  that  form  of  mange  with  which  we  are  most  conversant  is 
connected  with  the  existence  of  this  acarus. 


Fig.  121. — Dennatodectes  equi.— (Gerlach.) 


SYMBIOTES  EQUI. 


"  This  parasite,  like  the  dermatodectes  equi,  seems  to  live  only 
on  the  horse ;  and  it  is  readily  obtained  from  beneath  the  scales. 


SCABIES. 


691 


by  laying  the  latter  on  a  paper  in  the  sun,  where  next  day  they 
are  found  in  small  clusters." — (Gamgee.) 


Fig.  122. — Symbiotes  equi. — (Gerlach.) 

According  to  Mr.  Gamgee,  who  is  translating  from  Gerlach, 
the  finding  of  the  various  mites  which  constitute  so  essential  a 
feature  in  mange,  "  has  as  yet  been  attended  with  great  diffi- 
culty," and  the  various  procedures  for  their  detection  are  as 
follows : — 

(1.)  "  Animals  placed  in  the  sun,  and  carefully  examined ; 
the  acari  (sarcoptes)  do  not  get  on  tlie  surface  of  the  epidermic 
scales  and  on  the  hairs,  as  dermatodectes  do ;  and  these  can  be 
seen  with  the  naked  eye. 

(2.)  "  The  sarcoptes  are  found  below  the  scales  or  scabs, 
which  may  be  so  adherent  to  the  skin  that,  on  being  removed, 
the  latter  may  bleed.  The  dermatodectes  are  observed,  after 
the  animals  have  been  exposed  to  the  sun,  on  the  outer  part 
of  these  scales ;  but  the  sarcoptes  are  only  seen  on  the  inner. 
The  scales  examined  should  always  be  fresh,  and  they  may  be 
laid  on  black  paper  in  a  warm  place  in  the  sun,  and  then 
examined  by  a  weak  lens  embracing  a  wide  field  of  view.  The 
small  sarcoptes  are  only  discovered  when  the  cuticle  has  been 
removed  with  the  scab. 

(3.)  "  The  sarcoptes  are  most  certainly  and  easily  found 
when  the  scales  are  laid  with  their  under  surface  uppermost 
on  the  arm.     In  the  course  of  twelve  hours  they  pass  from  the 


692  DISEASES   OF  THE  SKIX. 

scales  on  the  arm,  and  burrow  into  tlie  skin  at  tlie  part  covered 
by  the  scab.  On  removing  the  latter,  the  parasite  is  seen  as  a 
white  spot  on  a  somewhat  reddened  skin,  or  upon  a  small  red 
papula.  With  the  point  of  a  needle  the  white  summit  of  the 
epidermic  vesicle  is  punctured,  and  the  sarcoptes  obtained.  If 
the  inflammatory  nodule  be  allowed  to  pass  to  the  state  of  a 
bladder,  then  the  mite  is  rarely  found.  If  there  be  only  a 
few  acari  on  the  scales  applied  to  the  arm,  the  red  points  or 
nodules  are  only  seen  next  day,  and  before  the  appearance  of 
this  eruption  the  insects  are  not,  as  a  rule,  to  be  found  on  the 
skin ;  if  many  of  the  parasites  exist  on  the  scales,  then  in  the 
course  of  a  few  hours  they  may  be  obtained  on  the  arm. 

"  The  dermatodectes,  esj)ecially  of  horses  and  cattle,  are 
readily  found  in  a  similar  way.  Sometimes  the  scales  need 
only  be  on  the  human  skin  one  hour. 

"  When  sarcoptes  are  sought  by  placing  scabs  on  the  skin  of 
the  arm,  lest  any  should  remain  bare  behind,  the  skin  should 
be  rubbed  with  a  little  oil  of  turpentine  or  some  oatmeal.  With 
the  other  forms  of  parasites  mentioned  this  precaution  is  un- 
necessary." 

Syiii'ptoms  of  Mange  in  the  Horse. — As  already  indicated,  there 
are  three  varieties  of  mange,  each  being  due  to  a  particular 
parasite,  which  seems  to  induce  symptoms  differing  in  some 
particulars.  The  first  variety  (sarcoptes)  causes  a  vesicular  erup- 
tion and  intense  itching,  which  increases  towards  night.  This 
pruritis  is  supposed  to  be  due  to  an  acrid  fluid  or  saliva  which  the 
parasite  deposits  in  the  gallery  in  which  it  is  lodged. 

The  favourite  seats  of  this  form  of  mange  are  the  sides  of  the 
neck  and  withers,  whence  they  may  extend  over  the  surface  of 
the  body,  except,  according  to  Mr.  Fleming,  those  parts  covered 
by  long  hair,  as  the  root  of  the  mane  and  the  tail. 

If  the  invaJed  parts  be  examined  by  the  hand,  small  hard 
pimples  may  be  felt,  which,  if  looked  at  closely,  will  be  found 
to  consist  of  a  small  scab  easily  removed,  exposing  round 
small  moist  surfaces  about  an  eighth  of  an  inch  in  diameter. 
The  character  of  this  form  of  scabies  is  eczematous,  and  at  a 
more  advanced  period  large  surfaces  become  destitute  of  hair, 
and  are  covered  with  dry  powdery  crusts  of  variable  thicknesses. 
At  a  later  period  the  skin  becomes  thickened,  wrinkled,  and 
fissured,  assuming  the  appearance  of  the  skin  of  the  rliinoceros. 


SCABIES.  693 

This  constitutes  the  chronic  or  inveterate  stage,  and  may  (as 
]\Iequin  asserts)  persist  for  a  long  time  after  all  traces  of  the  para- 
site have  disappeared — become,  in  fact,  constitutional,  where  the 
temperament  or  diathesis,  such  as  herpatism,  is  allied  with 
it.  The  disease  may  then  be  designated  chronic  lichen,  and  de- 
mands different  treatment. — (Fleming.) 

The  course  of  the  disease  is  slow  in  horses  well  fed  and  cared 
for ;  but  in  those  under  less  favourable  circumstances  it  spreads 
with  great  rapidity,  and  may  even  cause  death  from  irritation  and 
exhaustion.  Mr.  Fleming,  who  has  seen  the  disease  in  the  Crimea, 
says : — "  It  has  been  remarked  that  after  the  disease  had  been 
cured,  the  hair  on  the  affected  parts  grows  very  rapidly,  and 
longer  than  elsewhere ;  and  also  that  it  is  darker  coloured,  as  if 
the  poison  of  the  sarcoptes  had  exercised  a  specific  influence  on 
the  hair  bulbs." 

Symptoms  of  Dermatodedic  Scabies. — This  is  the  variety  of 
mange  usually  recognised  in  this  country ;  indeed,  I  am  not 
aware  of  having  seen  the  sarcoptic  form,  except  during  an  out- 
break which  occurred  in  1872-73,  and  which  was  conveyed  from 
Edinburgh  to  Melrose,  proving  fatal  to  several  horses.  It  is 
characterised  by  great  itchiness,  associated  with  the  formation 
of  papules  and  pustules.  The  papules  are  distinct  elevations 
about  an  eighth  of  an  inch  in  height,  and  a  third  of  an  inch  in 
diameter,  soon  having  upon  their  surface  a  vesicle,  that  is  quickly 
ruptured,  allowing  the  serous  contents  to  escape :  these  serous 
contents  dry  and  form  a  crust.  The  pimples  continue  to  dis- 
charge, and  the  crust  increases  and  continues  moist,  giving  an 
appearance  different  to  the  dry  powdery  sarcoptic  crust. 

These  parasites  invade  the  upper  border  of  the  neck  and  root 
of  the  tail ;  they  deposit  a  secretion  more  acrid  and  irritating,  and, 
having  long  mandibles,  they  thus  cause  more  serious  alteration 
in  the  skin  than  the  sarcoptic ;  but  notwithstanding,  this  form 
of  scabies  is  not  so  serious,  is  less  contagious,  spreads  more 
slowly,  and  is  more  easily  cured  than  the  other  form. 

Symptoms  of  Symbiotic  Scabies. — These  parasites,  like  the  der- 
matodectic,  live  in  colonies,  and  thus  differ  from  the  sarcoptic, 
which  lead  an  isolated  existence.  They  invade  the  limbs  of 
horses,  and  do  not  burrow  into,  but  merely  bite  the  skin,  causing 
the  production  of  serum,  which,  along  with  tlie  debris  of  the  epi- 
dermis, concretes  into  numerous  crusts  that  break  in  large  flakes. 


694 


DISEASES  OF  THE  SKIN. 


The  itching  which  they  cause  is  not  so  severe  as  in  the  other 
tTTo  forms,  and  they  are  much  more  stationary  than  the  derma- 
todectes,  the  bites  of  which  cause  an  exudation  and  a  thicken- 
ing of  the  epidermis,  w^hich  defies  the  further  action  of  their 
mandibles,  and  compels  them  to  attack  the  surrounding  healthy 
skin. 

Two  parasites  seem  to  infest  the  legs  of  horses,  viz.,  the  one 
above  described  and  the  sarcoptes  hippodus,  described  at  page 
672,  Fig.  116. 

To  complete  the  diagnosis,  the  presence  of  the  parasites  must 
be  determined,  see  Figs.  120,  121,  and  122,  it  being  remembered 
that  the  sarcoptic  variety,  owing  to  the  fact  that  the  female 
parasites  preponderate  very  largely,  are  unsociable  in  their 
habits,  are  fond  of  wandering,  are  more  contagious  than  the  der- 
matodectic,  and  much  more  so  than  the  symbiotic. 


MANGE  IN  THE  OX. 

Two  kinds  of  mites  have  been  discovered  in  the  mange  of 
horned  cattle : — (1.)  The  Dermatodectes ;  and  (2.)  Symbiotes 
bovis,  which  was  first  observed  by  Gohier,  upon  Hungarian  oxen. 


FiQ.  123. — Dermatodectes  bovis. — (Gerlaoh.) 


SCABIES. 


695 


SYMPTOMS  IN  THE  OX. 

The  symptoms  are  similar  to  those  in  the  horse.  The  derma- 
todectes  are  generally  observed  about  the  withers  and  root  of 
th^  tail,  and  soon  extend  to  the  whole  body,  except  the  limbs, 
causing  severe  itching,  a  falling  off  of  the  hair,  thickening, 
hardening,  and  corrugation  of  the  skin,  along  with  cracks  or 
fissures.  The  animal  rubs  and  licks  itself,  causing  wounds  and 
abrasions,  from  which  an  exudate  is  poured  out,  which,  along 
with  the  debris  of  the  epidermis,  forms  crusts. 

The  symbiotic  parasites  locate  themselves  about  the  base  of 
the  tail  and  vicinity  of  the  anus,  where,  unless  there  is  absolute 
neglect  of  cleanliness,  they  remain,  causing  irritation  and  forma- 
tion of  scabs. — (Fleming.) 


Fig.  124. — Symbiotes  bovis. — (Gerlach.) 


696 


DISEASES  OF  THE  SKIN". 


SCAB  IN  SHEEP. 


Three  forms  of  scab  are  described,  viz.,  the  sarcoptic,  derinato- 
dectic,  and  symbiotic.  The  dermatodectic  or  psoroptic  is  the 
common  form  known  in  this  country ;  it  is  intensely  contagious, 


Fig.  125.— Dermatodectes  ovis, — (Gerlach.) 

and  spreads  with  great  rapidity,  the  parasite  wliich  causes  it 


SCABIES. 


697 


propagating  most  rapidly,  as  the  following  table  furnished  by 
Gerlach  will  show : — 


meration. 

Days. 

Females  Bom. 

Males  Bom. 

1st     . 

.     .     15     .     . 

10     . 

.     .              5 

2cl      . 

.     .     30    .     . 

100     . 

.     .            50 

3d      . 

.     .     45     .     . 

1,000     . 

500 

4th.    . 

.     .     60     .     . 

10,000     .     . 

.       5,000 

bth.    . 

.     .     75     .     . 

100,000     . 

.     .     50,000 

6th.     . 

.     .     90     .     . 

.     1,000,000     . 

.     .  500,000 

Its  first  symptom  is  itchiness,  attempts  to  allay  which  soon 
give  the  animal  a  ragged  appearance,  tufts  of  wool  being  pulled 
out,  leaving  white  patches.  If  the  animal  be  caught  and  the  bare 
parts  examined,  a  slightly  prominent  pimple  of  a  yellowish  red 
colour  will  be  observed.  Upon  the  surface  of  this  pimple  a  small 
blister  or  vesicle  soon  forms,  its  contained  serosity,  being  dis- 
charged, forms  the  crust  or  scab,  and  at  a  little  distance  the 
parasite  may  be  discovered  amongst  the  wool.  If  the  bare 
patches  be  gently  rubbed  or  scratched,  the  sheep  will  express 
its  pleasure  by  rapid  movement  of  the  lips  or  smacking. 

The  parts  first  attacked  are  the  back,  sides,  and  shoulders, 
and  but  very  rarely  the  lower  parts  of  the  body  and  limbs. 

The  vesicles  soon  become  confluent  and  sometimes  pustular, 
the  wool  is  easily  detached  along  with  the  crusts,  and  the  under- 
lying skin  is  thickened,  wrinkled,  inflamed,  and  scaly. 

The  sarcoptic  variety  was  discovered  in  1838  by  Delafond,  the 
parasite  being  analogous  to  the  acarus  of  the  human  species. 

According  to  Mr.  Fleming,  "  its  first  indications  are  observed 
on  the  upper  lip  around  the  nostril,  and  rarely  on  the  eyelids 
and  round  the  ears,  by  its  appearing  as  a  weU-defined  vesicle 
with  a  red  areola.  Very  intense  pruritis  causes  the  animal  to 
lick  the  lip,  rub  the  parts  against  any  object  it  can  find,  or 
scratch  them  with  its  hind  or  fore  feet.  The  vesicle  is  in  this 
way  ruptured,  the  yellowish  serosity  it  contains  escapes,  and 
forms  a  round  hard  crust.  Analogous  papulse  and  vesicles  appear 
on  the  limbs  which  have  been  employed  in  rubbing  the  lip  and 
nose;  and  these  parts  are  soon  covered  with  dense  greyish 
crusts,  beneath  wliich  the  sarcoptes  congregate.  At  a  later 
period  the  disease  invades  the  whole  of  the  face,  cheeks,  eyelids, 
and  the  lower  portion  of  the  limbs ;  though,  strange  to  say,  it 
does  not  attack  those  parts  of  the  body  covered  with  wool.  Tlie 
diseased  patches  extend  and  become  more  numerous  and  co- 


698  DISEASES  OF  THE  SKIN. 

alesce ;  -until  at  length  such  a  region  as  the  face  presents  only  one 
large  crust  covering  the  skin,  which  is  indurated,  wrinkled, 
cracked,  ulcerated,  and  bleeding. 

"At  this  advanced  stage,  respiration,  vision,  and  even  the 
prehension  of  food,  may  be  obstructed  by  the  thickness  and  size 
of  the  crusts,  and  the  tumefaction  existing  around  the  natural 
openings.  A  fatal  termination  has  not,  however,  according  to 
Eeynal,  been  noted." 

I  am  satisfied  of  having  seen  one  case  that  was  on  the  point 
of  death  from  starvation  and  inability  to  breathe,  arising  from 
the  lips  and  nostrils  being  indurated  and  scabbed,  and  in  which  the 
parasites  were  discovered.  The  symbiotic,  like  that  in  the  horse, 
attacks  the  legs,  spreads  but  slowly,  and  is  not  very  contagious. 

Treatment. — The  first  essential  is  the  separation  of  the  healthy 
from  the  unhealthy  stock,  and,  as  a  precautionary  measure,  the 
healthy  sheep  should  be  dipped  with  any  of  the  reputed  dress- 
ings. A  very  efiectual  one  is  a  preparation  of  arsenic  (one 
pound  to  twenty  gallons  of  water)  rendered  soluble  by  the 
addition  of  an  equal  quantity  of  an  alkali ;  for  example,  the 
carbonate  of  potash.  Sheep  should  be  dipped  in  dry  weather, 
and  penned  for  the  night  after  the  operation,  to  prevent  them 
eating  the  drippings  from  the  wool  along  with  their  food. 
The  affected  stock  must  be  dressed  individually;  the  wool 
being  first  clipped  from  the  margin  of  the  scabbed  part  (as 
there  the  parasites  are  located),  and  the  part  then  dressed 
with  tobacco  juice,  mercurial  ointment,  spirit  of  tar,  or  sulphur 
ointment.  As  a  dip,  carbolic  acid  is  very  good,  but  it  has 
this  disadvantage,  that  it  destroys  the  colour  of  the  wool. 
The  flockmaster  must  remember  that,  though  he  may  have  de- 
stroyed the  parasite,  the  ova  yet  remain,  and  therefore  careful 
watching  is  necessary,  and  a  second  or  even  a  third  application 
of  the  dressing  may  be  required. 

This  disease  is  included  in  the  Contagious  Diseases  Act,  1869. 

The  dermatodectes  ovis  is  moderately  hard;  the  male  is 
roundish,  the  female  more  oval.  Each  of  the  external  posterior 
feet  has  two  long  bristles ;  the  fourth  pair  of  feet  in  the  male  is 
rudimentary.  The  horny  framework  of  the  feet  is  reddish 
brown.  In  order  that  the  reader  may  compare  the  delineations 
of  Gerlach  and  those  of  Kuchenmeister,  I  have  inserted  the 
following  cuts : — 


SCABIES. 


699 


Fig.  126. — Sarcoptes  ovis,  from  above.     Fig.  127. — Sarcoptes  ovis,  from  beneath. 

(After  Kdchenmeister.) 


MANGE  m  THE  PIG 

Is  due  to  the  presence  of  the  sarcoptes  suis  (see  Fig.  128)  which 
was  discovered  by  Gurlt,  and  afterwards  seen  by  Hertwig  and 
Gerlach. — (Gamgee.)     It  is  transmissible  to  man. 


MANGE  IN  the  DOG. 

Dog  mange  is  due  to  the  presence  of  the  sarcoptes  canis.  The 
disease  is  transmissible  to  man,  but  it  is  not  yet  shown  whether 
it  can  be  communicated  to  other  animals. 


'00 


DISEASES  OF  THE  SKIN. 


Its  si/mjjtoms  are  as  follows  : — Itchiness,  formation  of  red  points 
like  flea-bites,  vesicles,  pustules,  and  scabs. 

Where  the  skin  is  thinly  covered  with  hair,  as  upon  the  inside 
of  the  thighs,  under  the  abdomen,  &c.,  the  red  points  are  very 
apparent;  and  in  consequence  of  the  continual  itching  and 
scratching,  the  skin  upon  these  parts  becomes  red  and  inflamed. 


Fig.  128. — Sarcoptes  snis. — (Gerlach.)     Fig.  129, — Sarcoptes  canis. — (Gerlach.) 

Mr.  Fleming  is  quite  correct  in  stating  that  these  red  points  are 
due  to  the  presence  of  the  parasite,  although  "  red  mange  "  was 
generally  supposed  to  be  an  eczematous  disease.  I  have  satis- 
fied myself  that  it  is  parasitic  and  contagious,  and  that  what  are 
termed  scabby  mange,  watery  mange,  and  dry  or  red  mange,  are 
one  and  the  same  disease  differently  manifested.  The  mange 
louse  of  the  dog  is  the  habitat  of  the  cysticercus  cucumerinus ; 
hence  mangy  dogs  are  subject  to  tapeworm — Toenia  cucumerinus 
— from  swallowing  the  mange  parasites,  in  the  body  of  which  is 
looped  the  germ  of  what  becomes  developed  into  the  mature 
tapeworm  in  the  dog's  intestinal  canal.  Pups  suckled  by  mangy 
dams,  as  a  rule,  fall  a  prey  to  the  tapeworm  wlien  a  few  weeks 
old.  On  this  account  tlie  dam  ought  to  be  thoroughly  cured  of 
mange  before  the  birth  of  her  young. 


SCABIES. 


701 


FOLLICULAR  SCABIES. 


YiQ.  130. 


Fig.  131. 


Fig.  132. — Acari  folliculorum, 

fJg  Ul~'^fl^''^'^f  ^^  *^!  '^^  ^^*^^  ^^^'  containing  entozoa.     100  diam. 
^^Vt'voItS:!;'^^^^^^^  -staining  three  anin^aleul.  in 

towards\l^e7oSrS  th^  jts/oUicle,  in  which  may  be  seen  the  animalcule  descending 
lowaras  tne  root  of  the  hair  and  cul-de-sac  of  the  foUiclea.— (Gkubt.)     100  diam. 

This  form  Of  mange  is  due  to  the  presence  of  the  acanis 
demodox  foUiculorum.— (See  Figs.  130,  131,  and  132.) 


702  DISEASES  OF  THE  SKIN. 

In  the  first  edition  of  this  work  it  was  stated  that  "  this 
entozoon  is  not  known  to  cause  disease."  Shortly  after  the 
book  was  issued,  I  was  told  that  this  acarus  not  only  caused 
disease  in  dogs,  but  the  disease  was  considered  by  Continental 
veterinarians  to  be  incurable;  and  thanks  to  Mr.  Fleming 
(see  Veterinary  Sanitary  Science  and  Police,  vol.  ii.  p.  454), 
and  Mr.  W.  Hunting  (see  Veterinary  Journal,  September  1875, 
p.  167),  the  English  reading  veterinary  surgeons  were  made 
acquainted  with  the  symptoms  and  nature  of  this  form  of  mange. 

The  demodox  folliculorum  found  in  the  dog  is  identical  with 
that  in  the  human  beinsj,  in  whom  it  seems  to  cause  no  disease 
or  inconvenience.  Indeed,  according  to  Erasmus  Wilson,  the 
difficulty  seems  not  to  be  to  find  these  creatures,  but  to  find  any 
individual,  with  the  exception  of  newly-born  children,  in  whom 
they  do  not  exist.  Gruby  transferred  the  parasite  from  man  to 
the  dog,  in  whose  skin  it  both  hved  and  propagated.  This  dog 
was  kept  and  watched  for  two  years,  and  in  that  time  all  the 
hair  follicles  had  been  invaded,  and  the  hair  had  disappeared. 
Mr.  Fleming  thinks  that  there  may  not  be  a  specific  identity 
between  that  found  in  man  and  that  of  the  dog,  and  further 
experiments  would  be  interesting ;  but  the  result  of  the  experi- 
ment of  Gruby  is  very  strong  evidence  of  their  identity. 

This  parasite  measures  from  -g^  to  ^Jt  of  an  moh.  in  length, 
and  from  -5V  to  -g^  of  an  inch  in  breadth,  and  is  composed  of 
a  head,  thorax,  abdomen,  and  a  long  obtusely  pointed  tail. 

The  head  represents  in  form  a  truncated  cone,  flattened  from 
above  downwards,  and  is  furnished  with  two  maxillary  palpi, 
which  admit  of  extensive  motion.  The  thorax  is  the  broadest 
part  of  the  animal,  and  is  composed  of  four  segments,  and  having 
four  legs  on  each  side.  The  abdomen  varies  in  length  and 
admits  of  certain  movements;  internally  an  alimentary  canal, 
and  a  brownich  mass,  supposed  to  be  the  liver.  It  has  a 
mouth,  directed  obliquely  downwards  from  the  head,  and  an  anus 
at  the  opposite  extremity  of  the  body. 

The  parasites  inhabit  the  sebaceous  and  hair  follicles.  Their 
heads  are  directed  inwards  towards  the  base  of  the  folUcles ;  and 
when  very  numerous,  they  are  placed  back  to  back,  and  their 
feet  applied  to  the  walls  of  the  ducts. 

The  symptoms  and  treatment  are  so  well  given  by  Mr.  Hunt- 
ing, that  I  feel  I  can  do  no  better  than  quote  them. 


SCABIES.  703 

"  The  symptoms  of  the  disease  are  seldom  seen  in  the  first 
stages ;  they  consist  merely  of  circumscribed  spots  from  which  the 
hair  falls,  and  upon  which  are  noticeable  a  few  small  pimples. 
These  patches  extend  rapidly,  and  fresh  ones  appear  on  other 
parts.  Any  portion  of  the  skin  may  be  affected,  but  the  head, 
legs,  belly,  and  sides  are  usually  the  seat  of  the  disease.  The 
affected  places  are  almost  hairless,  and  what  hair  remains  is 
easily  pulled  out ;  small  pimples  and  pustules  stud  the  surface, 
the  latter  varying  in  size  from  a  pin's  head  to  that  of  a  pea.  The 
confluence  of  the  pustules,  and  the  discharge  of  their  contents? 
give  rise  to  scabs  ;  these  crack  and  bleed,  and  so  produce  a  most 
repulsive  appearance.  In  white-haired  dogs,  the  skin  is  red ;  in 
all  it  is  extremely  hot,  and  emits  an  unpleasant  odour.  The 
irritation  does  not  excite  much  scratching,  but  the  dog  frequently 
shakes  himself.  More  pain  than  itching  seems  to  accompany 
the  disease.  In  cases  where  the  whole  body  is  affected,  loss  of 
condition  is  most  marked ;  and  in  cold  weather  the  almost  total 
loss  of  hair  may  cause  death,  if  the  animal  be  not  kept  in  a  warm 
place.  This  stage,  too,  is  always  accompanied  by  a  ravenous 
appetite,  due,  probably,  to  the  rapid  loss  of  animal  heat. 

"  Diagnosis. — In  white  dogs  the  colour  of  the  skin  may  cause 
the  disease  to  be  mistaken  for  '  red  mange,'  or  '  eczema.' 
The  circumscribed  spots  in  the  first  stages  may  be  confounded 
with  some  forms  of  tinea ;  and  the  loss  of  hair  and  presence  of 
scabs  seen  in  the  fully  developed  disease  may  easily  be  mistaken 
for  ordinary  scabies.  The  pustules,  the  heat  of  the  skin,  and 
the  comparatively  slight  itchiness  shown,  are,  however,  nearly 
diagnostic.  Positive  diagnosis  can  only  be  made  by  the  aid  of 
the  microscope  and  the  detection  of  the  parasite.  If  we  puncture 
one  of  the  pustules,  and  mix  its  contents  on  a  slide  with  a  little 
water,  the  acari  are  easily  discovered.  I  have  found  as  many  as 
thirty  in  one  pustule.  Sometimes  we  may  detect  them  on  the 
root  of  a  hair  removed  from  an  affected  spot. 

"  The  disease  is  contagious,  but  not  to  such  an  extent  as 
scabies.  My  own  dog  had  been  in  daily  contact  with  an  affected 
one  for  a  fortnight,  and  showed  no  signs  of  the  malady.  In- 
oculation of  one  or  two  dogs  has  been  unsuccessful,  but  that  it 
is  contagious  is  beyond  doubt.  I  know  a  kennel  in  which  this 
disease  appeared  about  three  months  after  an  infected  dog  had 
been  allowed  to  live  with  the  others  for  a  week  or  two.     The 


704  DISEASES  OF  THE  SKIN. 

kennel  contained  about  half  a  dozen  dogs,  which  were  often 
changed ;  and  cases  of  the  disease  broke  out  in  this  place,  one 
after  another,  for  months. 

"  The  duration  of  the  disease  is  very  long.  I  have  seen  a 
case  of  two  years'  standing ;  but  I  do  not  think  this  length  of 
time  could  be  much  exceeded,  as  the  pitiable  condition  of  the 
animal  indicated  a  fatal  termination,  unless  treatment  had  been 
adopted.  I  am  inclined  to  think  that  the  development  of  the 
disease,  or  I  might  say  its  period  of  incubation,  is  very  slow. 
At  any  rate,  a  healthy  dog  remains  a  long  time  in  contact  with 
diseased  ones  before  he  shows  symptoms  of  it. 

"  Treatment. — My  first  two  or  three  cases  were  all  unsuc- 
cessful, and  it  was  not  until  I  compared  notes  with  Mr.  Duguid, 
the  veterinary  surgeon  to  the  Brown  Institution,  that  I  found 
this  was  the  experience  of  every  one  else.  We  then  worked 
together,  and  tried  preparations  of  mercury,  sulphur,  iodine, 
carbolic  acid,  and  other  parasiticides,  but  still  with  no  effect. 
These  substances  were  applied  either  in  watery  solutions,  or  in 
oil,  or  as  ointments,  and  were  used  of  various  strengths,  so  as 
in  some  cases  to  affect  the  system,  or  to  produce  a  caustic  action 
on  the  skin.  It  then  occurred  to  Mr.  Duguid,  that  as  the 
parasites  were  situated  deeply  in  the  skin,  any  application  to 
reach  them  must  first  soften  and  break  up  the  cuticular  covering. 
A  mixture  of  creosote  and  oil,  to  which  was  added  a  strong 
solution  of  caustic  potass,  was  tried,  and  its  action  was  soon 
most  marked.  To  facilitate  matters,  we  also  adopted  the  plan 
of  washing  the  dog  with  warm  water  and  soft  soap,  previous  to 
applying  the  dressing.  This  is  most  useful  in  all  parasitic  skin 
diseases,  but  in  none  so  conspicuously  as  this ;  as  it  softens  the 
cuticle,  and  removes  aU  scabs,  &c.,  allowing  the  drug  every 
chance  of  reaching  the  parasites. 

**  Carbolic  acid,  used  with  oil  and  caustic  potass,  is  not  effective, 
nor  is  any  drug  without  the  alkali.     Creosote  ointment  was 
tried  without   effect  by   Weiss.      Caustic  solutions   failed  in 
Haubner's  hands,  but  the  two  combined  are,  as  our  experience 
shows,  perfectly  reliable.     The  following  is  the  formula : — 
^  Creosote,       .       .       3iv. 
Olive  oil,       .       .       gvii. 
Sol.  potassae,        •       |i. 


SCABIES.  705 

Mix  the  creosote  and  oil,  then  acid  the  caustic  solution.  Dress 
the  affected  spots  about  twice  a  week,  and  allow  longer  intervals 
as  soon  as  the  skin  becomes  soft  and  tender.  In  cases  where 
the  whole  body  is  affected,  we  adopt  the  plan  of  shaving  the 
animal  as  soon  as  the  skin  is  sufficiently  smooth  for  the  action 
of  a  razor ;  and  in  all  cases  it  is  good  policy  to  shave  about  an 
inch  of  hair  off  the  sound  skin  all  round  the  diseased  spots. 
This  prevents  the  spread  of  the  parasites.  On  a  case  I  have 
now  under  treatment,  and  in  which  most  of  the  skin  was 
affected,  I  have  tried  clipping  instead  of  shaving,  and  with  good 
results.  I  fancy  the  absence  of  hair  not  only  allows  the  dressinfy 
to  act  better,  but  injuriously  affects  the  parasite.  If  this  really 
be  the  case,  may  it  not  account  for  the  difference  in  the 
symptoms  caused  by  the  parasite  on  man  and  on  the  dog  ? 

"  My  experience  as  to  the  renewal  of  hair  is  opposed  to  that 
of  Weiss,  who  states  that  it  is  not  regenerated.  I  find  that, 
except  upon  those  spots  where  small  ulcerations  have  been 
followed  by  a  cicatrix,  the  hair  is  reproduced,  and  that  it  grows 
rapidly,  but  not  until  the  parasites  are  totally  eradicated.  This 
is  remarkable,  as  one  would  naturally  expect  such  damage  as. is 
sustained  by  the  follicles  would  have  destroyed  their  function. 
When  we  had  cured  our  first  case,  we  certainly  did  not  expect 
the  renewal  of  hair,  and  were  not  a  little  agreeably  disappointed. 

"  A  cure  requires  from  three  to  eight  months,  and  even  a 
longer  time  than  this  must  be  allowed  for  the  growth  of  the 
hair." 

MANGE  IN  CATS 

Is  due  to  the  presence  of  the  sarcoptes  cati  (Gerlach),  which 

diffeTs  from  the  other  burrowing  mites 
only  in  its  relative  size.  It  lives  on 
the  skin  of  the  different  feline  animals, 
and  is  very  commonly  met  with,  in- 
ducing mange,  in  zoological  gardens 
and  travelling  menageries.  Like  the 
mange  of  the  other  animals,  it  is  highly 
contagious,  and  occasionally  all  the 
Fig.  133. --Sarcoptes  cati.—  cats  of  the  district  become  affected  with 
(Gerlach.)  the    disease,      Neglected    cat    mange 

presents  itself  as  a  very  loathsome  and  even  fatal  disease ;  the 

2z 


706  DISEASES   OF  THE  SKIN. 

animal  becomes  one  mass  of  scabs,  underrun  with  purulent 
matter,  emitting  a  most  loathsome  smell,  and  presenting  such 
evident  signs  of  distress,  emaciation,  and  debility,  as  to  call  for 
the  immediate  destruction  of  the  sufferer. 

Symptoms. — Great  itchiness  of  the  skin,  more  especially  when 
the  animal  is  warm,  or  at  night ;  a  peculiar  scaliness  and  under- 
mined state  of  the  epidermis ;  and  the  presence  of  the  acarus. 


TREATMENT   OF  SCABIES. 

True  mange  being  a  contagious  disease,  it  is  essential  that 
all  animals  suffering  from  it  should  be  isolated,  and  everything 
with  which  they  may  have  come  in  contact  purified.  Thus, 
with  horses  the  clothing  is  to  be  boiled  in  a  solution  of  soap 
and  carbolic  acid ;  and  the  harness,  saddle,  and  grooming 
utensils  washed  with  soap  and  warm  water,  and  dressed  with  a 
solution  of  arsenic  or  corrosive  sublimate,  in  the  proportion  of 
ten  grains  to  the  ounce  of  water.  After  being  so  washed  and 
dressed,  they  are  to  be  kept  for  several  days  exposed  to  dry 
air,  washed  again  with  soap  and  water  before  they  are  used ; 
and  before  they  are  again  put  on  the  horse,  they  should  be 
sprinkled  on  the  side  next  to  the  horse's  skin  with  sulphur. 
These  may  seem  useless  precautions,  but  in  many  cases  the 
harness  and  clothing  are  lined  with  thick  scabs,  containing  the 
ova  of  the  parasites,  the  vitality  of  which  is  so  great  as  almost 
to  defy  all  efforts  to  destroy  it. 

Pastures  in  which  scabby  sheep  have  been  grazing  should  be 
kept  empty  for  some  weeks  ;  all  posts  and  other  rubbing-places 
should  be  examined,  and  purified  with  carbolised  whitewash, 
and  all  adhering  portions  of  wool  carefully  removed  and  burnt. 

Scabies  being  a  local  disease,  is  curable  by  topical  remedies, 
and  it  may  always  be  got  rid  of  by  frictions  with  the  sunple 
sulphur  ointment.  For  horses,  dogs,  cattle,  and  cats,  this  alone  is 
generally  sufficient,  provided  it  be  properly  applied,  and  no  part 
affected  with  the  disease  left  untouched  with  the  remedy.  The 
sulphuret  of  calcium  is  also  highly  recommended  for  diffuse 
mange,  where  it  would  be  improper  to  cover  a  large  extent  of 
skin  with  an  impermeable  coating.  It  is  made  as  follows : — 
2  lbs.  of  sulphur,  1  lb.  of  quicklime,  and  16  lbs.  of  water. 
These  are  to  be  boiled  together,  and  continually  stirred  untO.  the 
infrredients  are  combined. 


SCABIES.  '  707 

In  liorse  mange  tlie  unguentum  staphysagriee  is  a  most  effective 
remedy,  and  I  should  conclude  that  a  decoction  of  stavesacre 
would  prove  as  effectual  in  sheep  scab  ;  but  I  have  no  actual 
experience  in  the  matter.  The  formula  for  the  ointment  is  as 
follows : — 

^  Pulv.  delphini  staphisagrise,  §ii. 

Adipis,  vel.  ol.  palmse,  §viii. 

01.  olivse.  .  .         §i. 

Mix,  and  digest  at  100°  in  a  sand-bath,  and  strain.  M.  Bour- 
guignon,  with  his  microscope,  watched  with  great  care  the  effects 
of  various  remedies  on  the  acari,  and  arrived  at  a  conclusion  that 
the  most  energetic  remedies  that  could  be  employed  for  their 
destruction  were  solutions  of  the  iodide  of  potassium  and  of  the 
iodide  of  sulphur,  which  killed  them  in  eight  minutes.  A  solu- 
tion of  the  extract  of  staphysagria  was  the  next  in  virulence, 
destroying  the  acari  in  fifteen  minutes.  To  prove  the  relative 
value  of  these  two  remedies,  the  following  experiments  were 
made : — The  hands  of  an  itch  patient  were  immersed  in  a  solu- 
tion of  the  iodides  for  two  hours,  so  as  to  strongly  impregnate 
and  colour  the  integuments.  On  examining  the  acari  immedi- 
ately afterwards,  they  were  as  lively  as  ever,  but  on  the  next  day 
they  were  all  dead  and  the  eggs  destroyed.  The  epidermis  was 
greatly  shrivelled,  and  in  three  days  complete  desquamation 
occurred,  carrying  with  it  acari,  grooves,  and  eggs,  and  leaving 
the  cutis  raw  and  tender.  The  action  on  the  skin  was  evidently 
too  strong.  A  bath  of  a  solution  of  the  alcoholic  extract  of 
stavesacre  was  then  made,  and  immediately  after  two  hours' 
immersion  of  the  hands  all  the  acari  were  found  dead,  and,  with 
one  exception,  the  eggs  destroyed.  So  far  from  irritating  the 
integument,  this  application,  at  once  caused  the  itching  to  cease, 
and  produced  such  a  calmative  effect  that  M.  Bourguignon  pro- 
poses it  as  a  local  remedy  for  inflammation.  The  eruptions  also 
appeared  to  be  rapidly  cured  by  it. 

Horses,  cattle,  pigs,  dogs,  and  cats  should  be  thoroughly 
washed  with  soft  soap  and  warm  water,  before  any  remedy  is 
applied  to  the  skin  for  the  destruction  of  parasites  and  the  cure 
of  mange ;  and  no  remedy  should  be  allowed  to  remain  on  the 
skin  for  more  than  three  days,  at  the  end  of  which  time  the 
animal  is  again  to  be  washed  and  the  remedy  reapplied.  When 
the  disease  is  due  to  the  sarcoptes,  the  ova  are  contained  in 


708  DISEASES  OF  THE  SKIN. 

galleries  beneath  the  epidermis,  and  it  is  very  possible  that  all 
are  not  reached  by  the  dressing  until  the  animal  has  been 
dressed  three  or  four  times. 

Smearing  sheep  with  greasy  ointments,  or  dressing  them 
extensively  with  oil  of  tar  or  mercurial  ointment,  is  a  very 
dangerous  practice,  and  often  causes  many  deaths.  They  prove 
injurious  to  the  animal  by  clogging  the  wool  and  rendering  the 
skin  impervous,  thus  preventing  the  cutaneous  exhalations,  and 
causing  the  accumulation  of  effete  materials  in  the  blood — car- 
bonic acid,  ammonia,  and  other  organic  products — which  are 
naturally  thrown  off  through  the  pores  of  the  skin.  The 
symptoms  of  the  disease  so  produced  are  hurried  breathing, 
small,  frequent  pulse,  blood-shot  eyes,  and  a  discharge  of  frothy 
mucus  from  the  nose  and  mouth.  The  post  mortem  appearances 
are  congestion  of  the  lungs,  the  trachea  and  bronchii  filled  with 
mucus,  and  the  great  veins  filled  with  a  dark-coloured  semi- 
coagulated  blood. 

In  mercurial  poisoning  the  symptoms  are  those  of  insalivation, 
purging,  redness  of  the  skin,  foetor  of  the  breath,  and  rapid 
sinking. 

Treatment. — The  animals  must  be  clipped  and  thoroughly 
washed  with  soap  and  water.  They  must  be  supported  by  stimu- 
lants, such  as  wine,  whisky,  or  other  spirituous  liquors,  after- 
wards treated  with  great  care,  and  have  good  food  and  warm 
shelter. 

DISEASES  DUE  TO  EPIZOA. 

The  second  class  of  parasites  that  infest  the  skin  of  the  lower 
animals  consists  of  insects  which  live  upon  the  skin. 


LICE, 

(Pediculidce,  class  insecta,  division  articulata,  and  order  anophura), 
are  parasites  destitute  of  wings,  hatched  from  eggs,  undergoing 
no  transformation  in  the  process  of  their  development,  but  shed- 
ding their  skins  a  certain  number  of  times.  The  state  of  lousi- 
ness is  termed  phthiriasis,  and  is  seen  in  poor,  half-starved,  or 
very  old  animals.  The  best  treatment  is  clipping,  if  the  hair  be 
long,  washing  the  animal  with  a  decoction  of  stavesacre,  one 
ounce  of  the  powdered  seeds  to  a  pint  of  water,  and  taking  care 


DISEASES  DUE  TO  EPIZOA.  V09 

that  the  animals  do  not  lick  themselves  for  some  time  after  the 
remedy  is  applied. 

Debility  seems  to  be  the  predisposing  cause,  rendering  the 
animal  a  proper  habitat  for  the  propagation  and  development 
of  these  parasites.  It  must  be  overcome  by  good  food,  tonics, 
and  cleanliness. 

One  form  of  lousiness  in  the  horse  deserves  special  mention, 

namely — 

POULTRY  LOUSINESS,  OR  PHTHIRIASIS  EQUL 

Attention  was  first  drawn  to  this  disease  by  Professor  Bouley, 
whose  observations  are  published  in  the  Veterinarian  for  April 
1851.  He  says — "  Its  commencement  is  instantaneous.  All 
at  once  the  horse  is  seized  with  violent  itching.  So  sudden  and 
irresistible  is  the  desire  the  animal  possesses  to  scratch  himself, 
that  he  is  not  easy  for  a  single  moment.  He  rubs  his  skin 
against  every  resisting  body  near  him,  stamps  the  ground  con- 
tinually, strikes  his  belly,  bites  every  place  he  can  reach  with 
his  mouth,  manifesting  by  his  continual  movements  the  burning 
itching  by  which  he  is  devoured.  At  night  his  torments  increase, 
so  much  so,  that  should  the  animal  be  abandoned  to  himself,  he 
rubs  and  bites  himself  to  that  degree  that  he  tears  his  skin,  and 
carries  portions  away  in  his  mouth,  denuding  himself  extensively 
of  his  scarf-skin ;  nor  does  he  relax  until  smarting  pains  succeed 
the  insupportable  torments  of  the  itching." 

The  itchiness  is  accompanied  by  an  eruption  of  very  small 
vesicles  on  the  skin — some  solitary,  others  in  greater  number, 
occupying  more  or  less  extent  of  surface.  These  are  succeeded 
by  depilation  of  the  epidermis  and  hair,  leaving  a  small,  perfectly 
circular,  bare  surface,  of  the  ^ize  of  a  lentil  or  the  smallest  silver 
coin.  The  formation  of  these  circular  spots  by  consecutive  des- 
quamations goes  on  rapidly  ;  in  a  few  days  a  horse  with  the  most 
shining  coat  may  be  spotted  over  with  circular  patches,  devoid  of 
hair,  and  in  the  course  of  a  week  the  hair  and  epidermis  wiU  be 
destroyed  over  a  large  extent  of  surface. 

The  disease  does  not  seem  to  interfere  with  the  general  func- 
tions, and,  apart  from  the  violent  itchiness  and  excitement  which 
the  animal  experiences,  he  appears  in  perfect  health.  "  When, 
however,"  says  M.  Bouley,  "  the  disease  becomes  of  long  duration, 
the  subject  of  it  wiU  be  apt  to  fall  off  in  his  appetite,  to  grow 


710  DISEASES  OF  THE  SKIN. 

thin,  and  to  lose  liis  condition  for  work  from  tlie  gradual  wasting 
of  his  powers." 

An  interesting  letter  was  published  by  Mr.  Henderson,  of 
London,  immediately  after  M.  Bouley's  communication.  Messrs. 
Moon,  Woodger,  and  others  have  since  drawn  attention  to  the 
matter:  all  agree  that  the  parasite  causing  this  disease  is  the 
hen-louse,  and  that  the  horse  becomes  subject  to  the  annoyance 
from  being  stabled  near  hen-houses. 

Treatment. — Eemove  the  cause,  and  wash  the  animal  with 
a  decoction  of  tobacco  or  staphysagria ;  whitewash  the  stables, 
and  observe  cleanliness. 


FLEAS — ^PULEX  lERITANS. 

Dogs  are  much  troubled  with  the  common  ilea ;  and  the  best 
remedy  for  it  is  the  Persian  insect  powder.  Its  prevention 
should,  however,  be  made  the  primary  object ;  and  this  can  only 
be  attained  by  attention  to  cleanliness.  JSTot  only  is  the  dog  to 
be  repeatedly  washed,  but  also  its  kennel ;  and  instead  of  straw, 
sawdust,  especially  pine  sawdust,  should  be  used  as  litter. 

TICKS. 

Ticks  belong  to  the  order  Acarida  (Acarida  magna),  and  family 
Ixodiadce.  They  are  found  on  the  skins  of  horses,  cattle,  sheep,  and 
dogs.  Some  have  their  mouths  in  the  form  of  a  sucker,  by  which 
they  fasten  on  the  skin ;  others  are  free,  and  have  no  sucker.  They 
attach  themselves  to  the  skin  so  deeply  and  firmly,  that  it  is 
impossible  to  remove  them  without  tearing  away  the  skin  to 
which  they  are  fixed,  and  they  multiply  so  rapidly  in  hot 
climates  that  animals  have  been  known  to  die  from  exhaus- 
tion. For  further  information  on  the  natural  history  of  those 
parasites,  I  beg  to  refer  the  reader  to  Kuchenmeister.  They 
generally  attach  themselves  to  the  jaws,  belly,  between  the 
thighs,  under  the  tail,  and  other  parts  of  the  animal  least  pro- 
tected by  hair. 

The  proper  treatment  for  their  destruction  is  to  cut  off  their 
bodies  with  a  pair  of  sharp  scissors,  or  to  kill  them  with  oil  of 
turpentine. 

The  common  sheep-ticJc,  or  ked,  as  it  is  called  in  Scotland, 


SCABIES.  711 

belongs  to  the  genus  melophagus.  It  is  of  a  dark  reddish  colour, 
destitute  of  wings,  and  is  so  tenacious  of  life  that  it  will  exist  in 
a  fleece  twelve  months  after  the  animal  is  shorn.  They  become 
numerous  in  winter,  and  are  best  destroyed  by  an  arsenical  dip. 

FAMILY  OF  BOT-FLIES  ((ESTRIDEA). 

In  this  division  the  eggs  are  deposited  in  the  skin  of  our 
patients,  and  are  there  developed  into  the  larvae  of  the  fly. 

The  female  oestrus  has  a  horny  ovipositor,  which  slides  out 
and  in,  like  a  telescope,  and  bears  five  teeth  at  the  end.  On  the 
one  hand,  it  has  been  asserted  that  this  ovipositor  is  used  as  a 
boring  apparatus  in  burying  the  eggs  at  the  moment  of  laying  ; 
on  the  other,  that  it  has  not  sufficient  strength  for  this  purpose, 
that  the  eggs  are  stuck  upon  the  hairs,  and  that  only  the  larvae 
bore  under  the  skin. 

The  bot  of  the  ox,  (Estrus  hovis,  is  best  known  in  this 
country,  and,  according  to  Mr.  Bracy  Clark,  it  is  the  largest 
European  species  of  this  genus.  It  is  not  unfrequently  seen  in 
country  situations,  on  the  backs  of  oxen  and  cows,  causing  the 
formation  of  tumours  as  large  as  pullets'  eggs  on  the  sides  and 
about  the  back  and  loins,  which  are  called  by  the  country 
people  warbles,  wornils,  wormuls,  and  sometimes  bots.  Further, 
Mr.  Clark  says — "  That  we  may  continue  the  history  of  these 
flies  with  some  degree  of  uniformity,  we  shall  commence  its 
operations  with  some  remarks  on  the  deposition  of  the  eggs. 
This  act  appears  to  be  attended  with  severe  suffering,  or  appre- 
hension at  least,  which  makes  the  cattle  run  wild  and  furious, 
and  gad  and  stray  from  the  pastures ;  and  hence  the  ancient 
epithet  of  gad-fly.  When  yoked  to  the  plough,  the  attack 
of  this  fly  is  attended  with  real  danger,  since  they  (the 
cattle)  become  perfectly  uncontrollable,  and  will  often  run 
directly  forwards  through  the  hedges,  or  whatever  obstructs 
their  way. 

"  When  cattle  are  attacked  by  this  fly,  it  is  easily  known  by 
the  extreme  terror  and  agitation  of  the  whole  herd.  The  unfor- 
tunate object  of  the  attack  runs  bellowing  from  among  them  to 
some  distant  part  of  the  heath  or  nearest  water ;  the  tail,  from 
the  severity  of  the  pain,  is  held  with  a  tremulous  motion  straight 
from  the  body,  and  the  head  and  neck  stretched  out  to  the 
utmost." 


712  DISEASES   OF  THE  SKIN". 

The  larva,  at  first  white,  smootli,  and  transparent,  enlarges, 
becomes  brown  in  colour,  and  when  it  has  attained  its  full 
growth,  effects  its  escape  from  the  abscess  by  pressing  against 
the  external  opening ;  and  finally  wriggles  itself  out,  drops  to 
the  ground,  and,  seeking  a  convenient  retreat,  becomes  a  chry- 
salis, and  then  a  fly. 

Bots  are  found  under  the  skin  of  domesticated  and  other 
animals  besides  the  ox,  and  also  in  man. 

•  The  tumours  caused  by  the  bots  in  cattle  are  sometimes  of 
the  size  of  a  walnut,  generally  situated  upon  the  back  and 
shoulders.  They  are  easily  cured  by  pressing  out  the  bot  with 
the  fingers. 

MAGGOTS. 

Maggots,  or  "  the  fly,"  are  very  troublesome  to  sheep  in  the 
sultry  months  of  the  year.  They  are  the  larvae  of  the  large 
blow-fly  hatched  from  its  ova,  deposited  in  the  fleeces  of  the 
sheep,  particularly  about  the  rump  and  tail  of  the  animal  when 
in  a  dirty  condition ;  the  filth  forming  a  proper  habitat  for  the 
growth  of  the  insect.  The  maggots  burrow  into  the  skin,  render 
it  sore,  causing  suppuration  and  deep  fissures.  The  sheep 
suffers  greatly,  loses  its  appetite,  is  dull,  and  dejected ;  and 
unless  the  maggots  are  destroyed,  and  the  wounds  kept  clean, 
death  may  result.  In  Australia  this  is  a  great  pest,  and 
not  only  are  sheep  liable  to  be  fly-blown,  but  men  are  often 
attacked  by  the  fly,  and  have  their  noses  and  mouths  filled  with 
maggots. 

Sores  of  all  kinds  are  liable  to  be  fly-blown  in  the  summer 
time  in  this  country,  and  wounds  of  the  feet  are  very  often 
found  at  this  time  of  the  year  to  contain  maggots. 

The  best  remedy  for  the  destruction  of  the  maggot  is  a  com- 
bination of  one  part  of  oil  of  turpentine  to  three  parts  of  oil. 


CHAPTER  XLI. 

DISEASES  OF  THE  SKIN — continued. 

FAVUS,  OR  HONEYCOMB  RING-WORM — EXPERIMENTS  OF  GRUBY — THE 
ACHORION  SCHONLEINII THE  YELLOW  CRUST  DUE  TO  THE  EXU- 
DATION  TRANSMISSIBILITY  OF   THE    DISEASE   FROM    ANIMALS    TO 

MAN,    AND    VICE    VERSA TINEA    CIRCINATUS THE    TRICOPHYTON 

DISCOVERED     BY     MALMSTEN IDENTITY     OF    FAVUS    AND     TINEA 

CIRCINATUS LETTER     FROM     MR.    M'GILLIVRAY    OF     BANFF 

TREATMENT  OF  RING-WORM. 

DISEASES  DUE  TO  VEGETABLE  PARASITES — DERMATOPHYTA. 

The  vegetable  parasites,  or  epiphytes,  which  cause  diseases  of 
the  skin,  are  microscopic  growths  belonging  to  the  lowest  class 
of  vegetable  existence,  namely,  the  fungi,  cryptogamia.  Most  of 
them  are  composed  of  simple  sporules,  germs,  or  cells,  placed 
side  by  side,  or  end  to  end. 

Two  forms  of  skin  diseases  traceable  to  vegetable  parasites 
are  now  pretty  well  understood ;  they  are  the  tinea  tonsurans, 
also  called  tinea  tondens  or  ring- worm,  and  favus,  honeycomb 
ring-worm,  or  scald-bead. 


FAVUS,  OR  HONEYCOMB  RING-WORM. 

This  is  a  disease  little  known  in  this  country,  and  is  described 
as  a  fungus  parasitic  disease,  composed  of  cup-shaped  scabs, 
sometimes  distinct  and  separate,  at  other  times  indistinct  or 
confluent.  These  fungi  are  capable  of  being  implanted  from  one 
animal  to  another,  from  man  to  animals,  and  animals  to  man ; 
and  Gruby  tried  the  effects  of  the  inoculation  of  the  parasite  on 
vegetables,  and  succeeded,  by  inoculating  the  bark  of  an  oak- 
tr^e,  in  getting  a  favus-cup  identical  with  that  which  grows  on 
the  heads  of  children. 


714 


DISEASES  OF  THE  SKIN". 


Pathology. — The  disease  depends  upon  a  cryptogamic  fungus, 
named  the  achorion  Schonleinii,  after  Schonlein,  who  was  the 
first  to  suggest  that  the  yellow  crusts  were  constituted  by  a 
vegetable  parasite.     The  primary  seat  of  the  parasite  is  in  the 


Fig.  134. 


Fig.  135. 


Fig.  134. — Branches  of  achorion  Schonlemii  in  an  early  stage  of  devel- 
opment, growing  from' molecular  matter,  and  mingled  with  epidermic 
scales,  from  a  very  minute  favus  crust. 

Fig.  135. — Fragments  of  the  branches  more  highly  developed,  with 
numerous  sporules  and  molecular  matter,  from  the  centre  of  an  advanced 
favus  crvist. — (Bennett.)     300  diam. 

depth  of  the  hair  follicle  outside  the  layer  of  the  epithehum, 
which  covers  the  root  of  the  hair,  and  which  forms  the  "  inner 
root  sheath  of  Kblliker." — (Aitken.) 

By  making  their  sections  of  the  favus  crusts,  and  treating 


Fig.  136. — Thalli,  mycelia,  and  sporidia  of  the  achorion  Schonleinii, 
(showing  the  mode  of  reproduction. —(Bennett.)     800  diam. 


PAVUS.  715 

them  with  liquor  potassa?,  the  vegetations  can  be  discovered 
microscopically — using  a  magnifying  power  of  300  diameters — 
to  consist  of  numerous  little  oval  or  rounded  bodies  ;  the  sporules 
of  the  fungus  having  a  diameter  of  about  -jro^oiT  of  an  inch.  A 
number  of  cells  united  end  to  end  form  simple  or  jointed  and 
branching  tubes,  developed  from  the  sporules.  Little  granules 
or  nuclei  may  be  seen  in  the  interior  of  the  spores.  The  tubes 
vary  in  diameter,  and  hairs  in  the  vicinity  of  the  favus  crusts 
are  impregnated  with  the  fungus. — (Bazin,  Deafer,  Aitken, 
Anderson.)  Mr,  Erichsen  considers  "  that  the  matter  of  favus 
is  a  modification  of  tubercular  disease  of  the  skin,"  and  this  view 
is  supported  to  some  extent  by  Bennett,  who  is  of  opinion  that 
the  tubercular  matter  furnishes  the  soil  from  which  the  mycoder- 
matous  vegetations  spring. 

Chemically,  the  matter  of  favus  has  been  found  by  Thenard 
to  be  composed  of  coagulated  albumen,  70 ;  gelatine,  17 ;  phos- 
phate of  lime,  5 ;  water  and  loss,  8  parts  in  every  100  parts. 

Of  the  transmissibility  of  the  disease  from  man  to  animals 
there  can  be  no  doubt;  the  translations  of  Mr.  Fleming  from 
the  Continental  journals  furnish  ample  proofs  of  this  fact.  I 
remember  some  years  ago  being  called  upon  to  attend  a  number 
of  animals,  at  a  farm  in  Yorkshire,  for  ring- worm,  the  crusts  upon 
w^hich  presented,  except  on  the  horses,  a  yellow  colour  and 
a  honeycomb  appearance.  The  disease  had  attacked  over 
twenty  horned  cattle,  three  horses,  some  dogs,  and  several  cats. 
One  fact  in  connection  with  this  outbreak  was,  that  the  cats 
were  very  fond  of  sitting  on  the  backs  of  the  cows  and  horses, 
and,  doubtless,  the  disease  had  been  caught  from  mice  by  the 
cats,  and  transmitted  by  them  to  the  other  animals  about  the 
place. 

Eemak  found  that  the  sporules  underwent  developmental 
changes  on  the  cut  surface  of  an  apple,  as  well  as  in  animal 
fluids  to  which  sugar  had  been  added ;  but  no  such  changes 
took  place  when  they  were  mixed  with  distilled  or  spring 
water,  the  serum  of  blood,  solution  of  albumen,  pus,  muscle,  or 
any  other  animal  tissue.  In  these  cases,  the  animal  tissue,  as 
well  as  the  favus  crust,  became  decomposed,  and  infusorial  forma- 
tions were  developed.  From  this  we  learn  that  the  achorion 
grows  under  the  same  circumstances  as  all  other  moulds. 
Inoculation   with   the   favus   crust    does   not   always   succeed, 


716 


DISEASES  OF  THE  SKIN. 


and  Bennett  is  of  opinion  that  it  is  necessary  to  have  cer- 
tain exudations  in  peculiar  states  of  the  constitution,  or 
disintegrated  matters  which  have  undergone  particular  chemical 
changes,  probably  from  acid  secretions  of  the  skin,  before  the 
disease  can  be  produced. 

Be  this  as  it  may,  it  is  very  true  that  filth  and  dirt  upon  the 
skin  constitute  a  favourable  soil  in  which  the  parasite  may  grow, 
provided  the  animal  be  subjected  to  a  source  of  contagion. 

In  all  probability  the  secretions  of  the  cutaneous  glands, 
accumulated  upon  the  surface  of  the  body,  and  there  undergoing 
the  acid  fermentation,  become  the  nidi  which  favour  the  growth 
of  the  favus. 

Symptoms. — The    disease   commences  with   a    slight  itching, 


c  d 

Fig.  137. — a,  Isolated  crusts  of  favus,  presenting  the  lupine  seed -like  depression 
in  different  stages  of  growth  (so  called  Porrigo  lupinosa)  ;  some  are  arranged  in 
groups  of  twos  and  threes,  b,  A  larger  group  of  these  crusts,  somewhat  ccmipressed 
at  the  sides  like  a  honeycomb  {Porrifio  favosa),  c,  Another  group,  which  occurred 
on  the  shoulder  of  a  young  girl  ;  no  hairs  passed  through  the  centre  of  these  crusts. 
d,  Large  isolated  crusts  in  an  advanced  state  of  growth  ;  the  external  ring  is  cracked, 
and  the  friable  centre  is  enlarged  and  elevated,  e,  Numerous  crusts  aggregated 
together  so  as  to  form  an  irregular  elevated  mass  ;  traces  of  the  original  form  may 
be  observed  in  the  cracked  rings  round  the  margin.     Natural  size. — (Bennett.) 

followed  by  an  eruption,  which  soon  assumes  the  appearance  of 
yellow  scabs  of  a  circular  form.  The  patches  of  eruption  are 
sometimes  very  numerous,  of  a  yellow  colour  when  recent,  but 
they  become  lighter  as  they  grow  older,  and  the  crust,  at  first 


FAVUS.  717 

rather  firm  in  consistence,  becomes  easily  reduced  to  powder. 
The  smell  of  the  scab  is  peculiar,  and  is  compared  to  the  urine 
of  a  cat,  or  to  a  cage  where  mice  have  been  kept.  This  is  sup- 
posed by  Dr.  Lowe  to  be  due  to  a  species  of  alcoholic  fermenta- 
tion {metliylamine),  in  connection  with  the  vegetable  growth. 
Wlien  a  crust  of  recent  formation  is  removed,  a  circular  depres- 
sion, wider  and  deeper  than  the  favus,  is  seen,  and  at  a  more 
advanced  stage  the  ulceration  penetrates  below  the  dermoid 
tissue. 

"  On  examining  the  hairs  which  pass  through  the  favus 
crusts,  it  will  be  often  found  that  they  present  their  healthy 
structure.  At  other  times  they  evidently  contain  long-jointed 
branches,  similar  to  those  in  the  crust,  running  in  the  long- 
axis  of  the  hair,  which  is  exceedingly  brittle.  There  can  be 
very  little  doubt  that  the  tubes  and  sporules,  after  a  time, 
completely  fill  up  the  hair  follicle,  and  thence  enter  the  hair, 
causing  atrophy  of  its  bulb,  and  the  baldness  which  follows  the 
disease." — (Bennett.) 


fC) 


Fig.  138. — a,  A  light  hair,  containing  branches  of  the  achorion 
Schonleinii  (magnified  300  diameters  linear).  The  wood-cutter 
has  made  the  branches  too  beaded:  h,  A  dark-coloured  hair,  con- 
taining branches  of  the  plant. — (Bennett.) 

Treatment. — The  disease  can  only  be  eradicated  by  the 
destruction  of  the  parasitic  growth,  and  as  a  rule  this  is  not  so 
difficult  to  accomplish  in  the  domestic  animals  as  it  seems  to 
be  in  man.  I  have,  however,  seen  some  very  aggravated  cases 
in  cats,  -but  the  severity  of  the  disease  was  due  more  to  neglect 
than  to  any  primary  virulence.  Corrosive  sublimate  made 
into  an  ointment  with  lard  is  recommended  by  M.  St.  Cyi\ 
The  iodine  ointment  seems  to  answer  very  well  in  this  country, 
but  before  it  is  applied,  the  scabs  are  to  be  removed  by  washing 
them  well  with  soft  soap  and  warm  water. 


718  DISEASES   OF  THE  SKIN. 

Many  preparations  are  recommended  by  physicians,  sncli  as 
a  solution  of  sulphate  of  copper,  or  of  the  nitrate  of  silver  in 
the  proportions  of  seven  grains  to  ten  ounces  of  water ;  unguen- 
tum  picis ;  an  ointment  of  the  cocculus  indicus,  3i.  to  3ii. ; 
adipis,  |i. ;  nitrate  of  merctiry  ointment,  a  solution  of  nitrous 
acid,  sulphureous  acid,  and  a  variety  of  other  remedies.  The 
application  of  the  stick  nitrate  of  silver  round  the  patches  is 
another  favourite  method  of  treatment,  and  when  all  these  fail, 
the  hairs  are  removed  singly  with  a  pair  of  forceps  (depilation.) 

TINEA  TONSUEANS. 

Piing-worm  is  a  common  skin  disease  in  the  lower  animals,  and, 
unlike  favus,  is  not  confined  to  those  ill  cared  for,  but  is  un- 
equally seen  amongst  carriage -horses,  hunters,  and  w^ell-groomed 
cattle,  and  is  defined  to  be  an  affection  implicating  the  hairs  of 
the  skin,  usually  assuming  a  circular  form.  The  hairs,  becoming 
dry  and  brittle,  have  a  tendency  to  crack  or  break  across  and 
fall  off,  leaving  isolated  patches  of  baldness,  constituting  w^hat  is 
termed  alopecia  circumscripta.  This  condition  is  more  particularly 
met  with  in  the  dog  ;  generally,  however,  an  erythematous  erup- 
tion, accompanied  by  slight  swelling  of  the  skin  and  some 
itchiness,  manifests  itself,  and  a  fungus  ultimately  appears,  which 
had  been  developing  between  the  true  sldn  and  epidermis.  This 
fungus  has  a  wliitish  appearance,  and  a  powdery  or  fine  bran-like 
aspect.  It  covers  the  epidermis  between  the  hairs,  and  forms 
around  them  a  complete  whitish  sheath.  The  hairs  break  un- 
evenly, become  ragged  at  their  ends,  and  have  the  appearance  of 
having  been  eaten  through ;  at  the  same  time  their  broken 
stumps  are  much  altered,  bent,  and  twisted,  and  are  lighter  in 
colour  than  the  healthy  hair. 

M.  Bazin  states  that  the  parasite  may  destroy  the  hair-bulb 
and  the  capsule  of  the  hair  follicle,  give  rise  to  the  formation  of 
pus,  and  cause  perfect  baldness  of  the  part. — (Anderson,  Bazin, 
HiLLiER,  Aitken.)  This  form  of  ring- worm  differs  from  the  vesi- 
cular form  (lierpes  circinatus)  by  the  absence  of  vesicles,  and  by 
the  formation  of  scurf  or  scales  around  single  hairs,  or  in  patches 
surrounding  several  hairs.  Again,  if  a  hair  in  the  vesicular  form 
be  pulled  gently,  the  probability  is  that  it  wiU  come  up  by  the 
root,  as  in  the  case  of  a  healthy  hair,  but  in  this  form  it  will  break 
off  near  the  skin,  or  within  its  follicle. 


TINEA  TONSURANS.  719 

Patliology. — "  The  nature  of  this  disease  is  to  be  studied  in  the 
botany  of  the  cryptogamic  parasite  called  the  Tricoj^liyton,  dis- 
covered by  Malmsten  in  1845.  It  consists  of  oval  transparent 
spores  or  globules,  about  -^Vxr  P^^^  ^^  ^^  iwoh  in  diameter. 
Many  of  these  are  isolated,  others  constitute  by  their  juxtaposition 
articulated  filaments.  Its  anatomical  seat  is  the  interior  of  the 
roots  of  the  hair.  The  hairs  and  fungi  simultaneously  increase ; 
the  former  seem  larger  than  usual,  are  paler  in  colour,  lose 
their  elasticity,  soften,  and  break  off  when  they  have  risen  some 
one  or  two  lines  above  the  surface." — (Aitken.) 

Eing-worm  may  affect  any  part  of  the  animal  body,  but  its 
favourite  seats  appear  to  be  the  hind  quarters,  back,  neck,  and 
face.  It  is  a  contagious  disease,  and  depends  upon  the  presence 
of  the  vegetable  parasite  already  described.  It  differs  from  favus 
in  the  colour  of  the  scabs,  which  are  greyish-white  instead  of 
yellow.  The  microscopic  appearance  of  the  plant,  its  structure, 
and  its  powers  of  propagation  are  identical  with  the  Achorion 
Schonleinii.  "  There  are  numerous  facts  which  justify  the  belief 
that  there  exists  but  one  essential  fungus,  whose  sporules  find  a 
soil  for  development  and  growth  upon  the  surface,  or  even  within 
more  secluded  portions  of  the  body ;  and  that  varieties  in  the 
gi'owth  of  that  fungus  are  due  to  differences  in  the  constitution 
of  the  individual,  to  the  moisture,  exudation,  soil,  or  temperature 
under  which  the  development  of  the  fungus  takes  place.  The 
exact  nature  of  these  differences  is  not  yet  understood ;  but  the 
X)roduction  of  irritant  acids  and  gases  are  constant  accompani- 
ments of  the  growth  of  such  parasites,  by  the  chemical  action  of 
the  vegetable  cell ;  for  it  does  not  undergo  development  without 
exciting  a  chemical  decomposition  in  the  pabulum  on  which  it 
feeds,  and  the  different  stages  in  its  growth  give  rise  to  alcoholic 
acid  and  putrefactive  fermentations.  Thus  their  irritant  action 
very  soon  may  establish  an  eruption.  But  the  ratio  of  eruption 
to  parasite  is  not  constant ;  for  an  amount  of  fungus  which  will 
simply  produce  the  death  of  hair  in  one  person  or  part  of  the 
body,  may  in  another  produce  irritation,  eruption,  or  violent 
inflammation.  These  different  results  may  be  due  to  two  causes 
— (1),  constitutional  peculiarity  in  different  individuals  ;  (2), 
peculiarity  of  structure  of  a  part  as  regards  density,  heat,  mois- 
ture, and  chemical  and  anatomical  composition  of  the  part." — 
(Aitken,  Lowe.) 

Experiments  are  wanting  to  prove  the  possibility  of  the  ring- 


720  DISEASES  OF  THE  SKIN. 

worm  crust  of  the  horse  producing  the  favous  crust  of  the  dog 
and  cat,  and  vice  versa;  but  from  the  foregoing  observations, 
and  from  the  opinion  of  Bennett,  already  quoted,  that  acid 
secretions  favour  the  development  of  the  favous  crust,  and  from 
microscopic  researches  into  the  identity  of  the  parasites,  I  am 
almost  inclined  to  conclude  that  the  ring-worm  of  the  horse  may 
be  the  favous  of  the  cat  and  dog,  and  that  the  yellow  crust  of 
the  latter  animals,  and  the  more  rapid  development  of  the 
fungus,  are  due  to  the  natural  acid  condition  of  their  cutaneous 
excretions.  ^ 

The  following  woodcut  of  the  microscopic  anatomy  of  the 
parasite  of  ring-worm  is  from  original  drawings  by  Professor 
Vaughan  of  this  College.  The  scab  from  which  the  specimen 
is  prepared  was  removed  by  me  from  a  carriage  horse,  the  pro- 
perty of  David  Corsar,  Esq.,  of  Arbroath.  The  ring- worm,  a  soli- 
tary patch,  was  situated  on  the  off-side  hind  quarter,  and  pre- 
sented the  usual  appearance  of  the  affection,  namely,  a  round, 
baldish  patch,  covered  by  a  greyish- white  crust. 

Treatment. — The  treatment  of  ring-worm,  like  that  of  favus, 

^  The  opinion  I  had  ventured  to  express  as  to  the  identity  of  Tinea  fav^osa  and 
Tinea  circinatus,  and  that  the  colour  of  the  crust  depended  upon  the  constitution 
of  the  animal,  was  very  fortunately  confirmed  by  Mr.  M'Gillivray  of  Banff,  in  an 
admirable  paper  on  Porrigo,  published  in  the  Veterinarian  for  March  1872.  After 
reading  Mr.  M'Gillivray's  paper,  I  took  the  liberty  of  asking  him  a  few  queries 
upon  the  subject  ;  and  I  feel  I  can  do  no  better  than  publish  the  answer  I  received 
by  return  of  post  : — 

"  No.  4  Bridge  Street,  Banff,  Qth  March  1872. 

' '  My  dear  Sir — Your  letter  came  to  hand  this  forenoon,  and  it  gives  me  the 
most  sincere  pleasure  to  answer  your  queries,  as  follows  : — 

"1.  As  a  rule,  yellow  crusts  are  not  found  in  ring- worm  in  horned  cattle.  I 
have,  however,  seen  genuine  favous  crusts  in  two  such  cases. 

"  2.  Contagious  materiel  from  the  grey  crust  of  cattle  or  horses  undoubtedly  (in 
60  far  as  my  experience  goes)  produces  often,  but  not  invariably,  the  characteristic 
yellow  crust  of  favus  in  the  human  subject. 

"  3.  The  crusts  or  scabs  of  Porrigo  in  the  dog  are  generally  greyish  in  colour. 
In  the  cat  I  have  invariably  found  them  of  a  very  bright  yellow.  In  the  hare  I 
never  saw  them  otherwise  than  greyish  to  the  naked  eye. 

'*  So  much  for  your  '  queries.'  My  own  candid  opinion  is  that  the  class  of  the 
animal  has  a  good  deal  to  do  with  the  colour  of  the  superincumbent  crust  or  scab 
of  porrigo  or  tinea.  This  is  the  only  satisfactory  way  of  accounting  for  the  fact  of 
grey  crusts  in  cattle  producing  yellow  crusts  in  man. 

"  I  am,  my  dear  Sir,  faithfully  yours, 

"Alex.  M'Gillivray." 
"W.  Williams,  Esq., 

Principal,  Veterinary  College,  Edinburgh.'* 


TINKA  TONSURANS. 


721 


consists  in  the  destruction  of  the  cryptogamic  plant.     This  is 
effected  by  the  application  to  the  spots—  after  first  removing 


Fig.  139. — Microscopic  appearance  of  ring- worm  crust  after  the 
addition  of  liquor  potassse.  a,  a,  Large  branch  of  the  achorion, 
showing  thalli  in  an  advanced  condition,  with  sporules  arranging 
themselves  end  to  end.  h,  c,  Hair  containing  the  plant  in  an  early 
stage  of  development :  at  6  the  fungus  is  distinctly  seen  in  the 
centre  of  the  hair-tube  ;  at  c,  the  hair  is  represented  as  yet  uninvaded 
by  the  parasite.  d,  d,  Scattered  sporules.  e,  e,  Hair  irregularly 
enlarged,  with  its  cortical  layer  broken  down  by  the  growing  parasite. 
200  diameters. 

the  crusts  by  washing  the  parts  with  warm  water,  soft  soap, 
and  carbonate  of  potash — of  the  iodine  ointment.  To  prevent 
a  recurrence  of  the  disease,  the  stable  should  be  thoroughly 
cleaned  and  whitewashed,  the  harness  and  collars  carefully 
washed  with  soap  and  water,  then  brushed  over  with  a  solution 
of  iodine  or  corrosive  sublimate,  and  the  clothing  of  the  animal 
boiled. 


3a 


INDEX. 


PAGE 

Abdojiinal  Parietes,  Wounds  of,  .  463 

xVbscess,        .         .         .         .         .  31 

,,      Acute,       ....  35 

,,       Chronic,    ....  31 

,,      Cold,          ....  31 

,,       in  Substanqe  of  Bone,          .  176 

,,       Post- Pharyngeal,        .         .  528 

Acarus  Scabie,       .         .         .         .  687 

Acne,  ......  683 

Aconite  in  Inflammation,        .          .  73 

Actual  Cautery,     ....  323 

,,             in  Treatment  of  Grease,  676 

Acute  Abscess,      .         .         .         .  35 

Adhesion,      .         .         .          .          .  27 

,,       Primary,  ....  480 

After    Birth,    Hernia    occuriiug,    and 

Causes,      .....  574 

Air  into  Veins,  Entrance  of,  .         .  576 
^Vitken  and  Lowe  on  Pathology  of 

Ping- Worm,  .         .          .          .  720 

Albugo  or  Leucoma,       .          .          .  545 
Alison,  Dr.,  on  Blood-Letting  in  In- 
flammation,       .          .          .          .  68 

Alkalies  in  Inflammation,       .          .  73 

Alveolar  Processes,  Diseases  of,     .  506 

Amaurosis,   .         .         .         .         .  548 

,,         after  Castration,    .          .  649 

Amputation  of  Penis,    .          .          .  635 

Anatomy  of  Bones,         .         .          .  149 

Anchylosis  of  Vertebra,         .          .  203 

,,           or  Stiffening  of  Joints,  228 
Anderson  on  Detection  of  Fractured 

Olecranon,          .         .         .         .  133 

Aneurism,     .         .         .          .         .  581 

,,         Dissecting,    .          .         .  584 

,,         Varicose,       .          .          .  585 

Aneurisms,  Palse,           .          .         .  584 

Aneurismal  Varix,          .          .          .  585 

Animal  Parasites,           .          .          .  085 

Antero-Iliac  Spine,  Fracture  of,     .  122 

Antero-Maxilla,  Fracture  of,          .  98 

Antimony  in  Inflammation,              .  73 

Aphthae,  Sporadic,          .         .         .  495 

Arterial  Coats,  Degenerations  of,   .  586 

,,       Calcareous  Degeneration  of,  586 

,,       Cartilaginous  Degeneration  of,   587 

,,       Fatty  Degeneration  of,     .  587 

Arteries,  Injuries  to,      .          .          .  588 

Arteries  and  Lymphatics,  Diseases  of,   578 

Arteritis,           .         .         .  578 

,,       Letter  on,  from  Pro- 


P.\r.B 


fessor  Barlow, 


i78 


Arteries  and  Lymphatics,  Diseases  of 
— continued. 
,,       Thrombosis,  Virchow  on, 
.,       Aneurism, 
,,  ,,         Spence  on, 

.,       Treatment  of, 
,,       Dissecting  Aneurism, 
,,        False  Aneurisms, 
, ,       Aneurismal  Varix,    . 
,,       Varicose  Aneurism,  . 
,,       Degeneration     of    Arteiiid 

Coats,  .... 
,,        Calcareous  Degeneration  of 

Arterial  Coats, 
,,        Cartilaginous  Degeneration, 
,,       Fatty  or  Atheromatous  De- 
generation, 
,,       Injuries  to  Arteries, 
, ,        Lymphatics,     Inflammation 

of.  Lymphangitis, 
,,       Mr,  Haycock  on, 
,,       Causes  of, 
. ,       Treatment, 
, .       Elephantiasis, 
Arteritis, 

Arthritis,  Rheumatoid, 
Articulations,    Gliding,     of    Hocks, 
Diseases  of,        ...  . 

Back-Rope,  Evil  of,       . 
Bandages,  Kinds  of. 
Barlow,  Professor,  on  Arteritis, 
Bearing-Rein  a  cause  of  Poll-Evil  . 
Benign  or  Simple  Tumour,     . 
Bennett,  Dr. ,  Classification  of  Skin . 

,,       Diseases,  .  .  . 

,,        on  Counter-Irritation, 

,,       on  Favus, 

, ,       Effect  of  Mercury  on  Bone, 
Bistouri  Cach^  for  Quitter,    . 
Bits,  Severe,  .... 

Bladder    and    External   Organs    of 

,,  Urination,  Diseases  of,  . 

,,        Urinal  Deposits, 

,,       Causes   and    Symptoms    of 
Deposits, 

,,       Cystic  Calculus,    Examina- 
tion for, 

, ,        Calculus  in  Mare,  Removal  of, 

,,        J  lithotomy  in  Horse  or  Gelding, 
,,^        in  Ox, 

,,        Calculi,  Urethral, 


580 
581 
581 
583 
584 
584 
585 
586 

586 

586 

587 

587 
588 

589 
590 
■591 
592 
593 
578 
210 

302 

120 

84 
578 
508 
427 

657 
320 
718 
200 
390 
494 

623 
623 

625 

626 
626 
627 
629 
G29 


724 


INDEX. 


Bladder  and  External  Organs  of  Urina- 
tion, Diseases  of — continued. 
,,        Sabulous  Matter,  Removal  of,  630 
,,       Generation,  Diseases  of  Ex- 
ternal Organs  of,     .         .  630 
,,       Urethritis,    Symptoms   and 

Treatment,     .         .         .  630 

, ,       D'Arbovalon  Syphilis  in  Horse,  631 
,,       Ph^'mosis,      Percivall     and 

D'Arboval  on,         .         .  632 

,,       Paraphymosis,  Treatment  of,  632 

..       Penis,  Amputation  of,        .  635 
.,       Hydrocele     or    Dropsy    of 

Scrotum,         .         .         .  635 
,,       Vagina  and  Mammary  Gland, 

Diseases  of,     .         .         .  636 
,,       Vaginitis,   or  Inflammation 

of  Vagina,      .         .         .  636 

,,       Treatment  of,    .         .         .  637 
,,       Mammitis,  or  Inflammation 

of  Mammary  Gland,        .  638 

,,       Treatment  of,              .         .  640 

Bleeding,  Local  and  General,           ,  70 

Method  of,          ...  70 

Blistering,  Hints  on,       .         .         .  322 

Blisters, 321 

Blood  Effusion,       ....  29 

,,     Inflammatory  Appearances  of,  65 

Blood -Letting  in  Inflammation,      .  67 

,,           Influence  opposed  to,  67 

,,           Second,     ...  70 

Blood-Spavin,          ....  301 

Bog-Spavin,             ....  299 

Bones,  Fractures  and  Diseases  of,   .  78 

Modes  of  Fracture,      .         ,  78 

Symptoms  of  Fracture,        .  79 

Modes  of  Union,          .         .  79 

Formation  and  Kinds  of  Callus,  80-81 

Stages  of  Repair,  according  to 

Dupuytren,                .         .  81 

Microscopic  Characters  of  New,  83 

Treatment  of  Fractvires,      .  83 
Splints  and  Bandages,  Kinds  of,    84 

Block  Tin  Splints,       .         .  85 

Compound  Fractures,           .  86 

Treatment  of,                .         .  86 

Unpropitious  Symptoms,     .  87 

Separation  of  Epiphyses,     .  87 

False  Joints,        ...  88 

Treatment  of,      .         .         .  89 

Syme's  Treatment,       .         .  89 

Causes  of  Non-Union,          .  89 

Particular  Fractures  of,        .  91 

Fracture  of  Inferior  Maxilla,  91 

Treatment  of,     .         .         .  91 
From   Pressure  of  Bit,   and 

Treatment,       ...  92 

Symptoms  of  Fracture  by  Curb,  92 

from  Punching  out  Incisors,  93 
Fracture  of  Ramus  of  Lower  Jaw,  93 


Bones,  Fractures  and  Diseases  of — continued. 

,,        Prof essor  Varnell's  Treatment  of,   94 

,,  Treatment  by  Mr.  Wallcer's 
Apparatus, 

,,       Treatment  by  Gutta-Percha, 

,,       Fracture  of  Antero-Maxilla, 

,,        Fracture  of  Nasal, 

,,       Professor  Varnell's  Treatment  of, 

,,  Removal  of  Necrosed  Frag- 
ments,     .         .         .         .    ' 

,,  Fracture  of  Superior  Maxilla, 
and  Treatment, 

,,       Fracture  of  Frontal,    . 

,,       Treatment, 

,,       Tendencji^  to  Tetanus, 

,,       Haemorrhage  in, 

,,       Comphcations  of, 

, ,       Fractures  of  Cranial  Bones, 

, ,       Kinds  of,  ... 

,,       Simple  Fissure,  . 

, ,  Simple  Fracture  with  Depres- 
sion, .... 

,,       Trephining, 

,,       Punctured  Fracture,  . 

,,       Compound  Fracture, 

,,  of  Crest  of  Occiput,  common 
in  Coal  Pits,  Prevention, 

,,  Concussion  of  the  Brain,  Col- 
lapse, Reaction,  and  In- 
flammation of, 

, ,  Different  ways  in  which  Con- 
cussion proves  fatal, 

,,       Post  Mortem  Appearances, 

,,  Mr.  Liston's  Theory,  Treat- 
ment,       .... 

,,       Haemorrhage, 

, ,  Syme's  Method  of  Trephining 
the  Cranium,    . 

,,       Hernia  Cerebri  and  Treatment, 

,,  Fractures  of  Vertebrae,  Wry 
Neck,       .... 

, ,       Fistulous  Withers, 

,,       Broken  Back, 


95 
97 
98 
98 
,  99 

99 

101 
101 
102 
102 

103 
103 
104 
104 
105 

105 
106 
107 
108 

109 


109 

110 
112 

112 

115 

115 
116 

117 
118 
118 


Fracture  without  Displacement,  118 

Fracture  during  Operations,  1 20 

EvUofthe  "Back-Rope,"  121 
Fractiu-es    of    Sacrum,    and 

Treatment,  .  .  .  121 
Fractures     of    Coccyx,    and 

Treatment,       .         .         .  122 

Fractures  of  Pelvic,     .  ,  122 

Fracture  of  Anterior  Iliac  Spine,  122 
Exact  Seat  of  Fracture,  how 

determined,       .  .         .  123 

Fracture  through  Symphisis 

Pubis,  ....  125 
Fractures   of    Tuberosity   of 

Ischium,  .  .         .  125 

Fractures  of  Femur,   .         .  ]  25 

of  Trochanters,  .         .  126 


INDEX. 


725 


Bones,  Fractures  and  Diseases  of — continued. 
Fracture  of  Patella,  .  .  127 
of  Tibia,  ....  128 
of  Calcis,  Treatment,  .  129 
of  Scapula,  .  .  .  131 
of  Humerus,  Recovery  im- 
possible, .  .  .  131 
of  Radius  and  Ulna,  .  132 
of  Olecranon,  transversely,  133 
Mr.    Anderson's   Method  of 

Detection,  .  .  .  133 
Treatment,  .  .  .  134 
in  Bones  of  Knee,  .  .  135 
Metacarpal  and  Siiffragiuis,  135 
Split  Pastern,  .  .  136 
Sesamoids,  Recovery  impossible,  137 
of  Navicular,  .  .  .  137 
of  Pedal,  ....  139 
Treatment,  .  .  .  140 
Broken  Ribs,  ...  140 
Treatment,  .  .  .  141 
Luxations  or  Dislocations  with- 
out Fracture,  Case  of,  .  142 
of  Patella,  .  .  .  142 
Treatment,  .  .  .  143 
Partial  Dislocations  of  Fet- 
lock-Joints, .  .  .  144 
Dislocation  of  Head  of  Femur 

impossible  in  Horse,  .  144 
Dislocation  of  Carpus  in  Dogs,  144 
Case  of  Dislocation  of  Cer- 
vical Vertebrte,  .  .  145 
Classification  of,  .  .  148 
Anatomy  of,  .  .  .  149 
Ostitis,  or  Inflammation  of,  151 
Ostitis  and  Periostitis  of  the 

Metacarpals,  or  Sore  Shins,  153 

Symptoms,         .         .         .  154 

Splints,                .         .         .  155 

Kinds  of  Splints,         .         .  156 

Produce  Lameness,  when,  .  157 

Peculiarity  of  Lameness,     .  158 

How  to  distinguish  it,          .  158 
and   Articulations,    Diseases 

of.  Splint,  Treatment  of,  159 

Subcutaneous  Periosteotomy,  159 

Pyro-Puncture,           .          .  159 

Scrofulous  Ostitis,       .         .  160 

Causes  and  Pathology,        .  162 

Treatment,          .         .         .  163 

Ulceration  and  Caries,  Syme  on,  165 

Treatment,         .         .         .  168 

Necrosis,             .         .         .  168 

Pathology  of,     .         .         .  171 

Treatment,          .         .         .  172 

Necrosis,  Internal,   rare,     .  174 

Subperiosteal  Suppuration,  175 

Abscess  in  Substance  of ,      .  176 

Diagnosis  and  Treatment  of,  176 

Diseases  of,  Non-Inflanunatory,  178 


Bones,  Fractures andDiseases of — contin  ued. 

,,       Rickets  or  Rachitis,             .  178 

,,       Treatment  of,              .         .  180 

,,       Rokitansky  on,           ,         .  181 

,,       MolHties  Ossium,         .         .  182 

,,       Cases  of,             ...  183 

,,       How  accounted  for,    .          .  184 

,,       Osteo-Porosis,              .          .  184 
, ,       Post  Mortem  Appearance,  by 

Professor  Varnell,  .         .  189 

,,       in  Sheep,  Mr.  Robertson  on,  193 

,,       Rokitansky  on,            .         .  195 

,,       Fragilitus  Ossium,       .          .  197 

,,       Osteo- Sarcoma,            .         .  199 

,,       Treatment,          .         .         .  200 

,,       Effects  of  Mercury  on,         .  200 

, ,        Case  by  Professor  Bennett,  200 

Bones  of  Knee,  Fracture  of,            .  135 

Bone-Spavin,         ....  301 

Bot  Flies,               ....  711 

Bouley  on  PovJtry  Lou.siuess,          .  709 

Bourguignon  on  fcjarcoptes  Homiuis,  686 

Brain,  Collapse  of,         .          .         .  109 

,,       Concussion  of,     .         .         .  109 

Bridle   for   preventing   Fracture  of 

Occiput,              .         .         .         .  109 
Broad's,   Mr.,    Shoe  for  Laminitis, 

and  Treatment  of,      .         .         .  367 
Broad,  Mr.,  on  "Mud-Fever,"  and 

Treatment  of,             ...  661 
Broken  Back,        .         .         .          .  118 
,,           Fracture  with  and  with- 
out Displacement,  118 
Broken  Knees,      .         .         .         .  270 
„             Eands  of,        .         .  270 
Broken  Ribs,          .         .         .         .  140 
Bronchocele,          ....  442 
Bruises  of  the  Mouth,   .         .         .  494 
Brushing  or  Cutting,     .         .         .  463 
Bubonocele,           ....  602 
Buccal  Membrane,  Affections  of,    .  494 
Buchanan,  Dr. ,  Classification  of  Skin 

Diseases,             .         .         .         .  658 

Butfy  Coat,            ....  66 

Burdon  Sanderson  on  Inflammation,  15 

Burns,  Scalds,  and  Effect  of  Cold,  465 

Calcareous  Degeneration  of  Arterial 

Coats,         .         .         .  586 

,,         Tumours,      .         .         .  436 

Calcification  of  Synovial  Fringes,   .  210 

Calcis,  Fractures  of,      .         .         .  129 

Calculi,  Salivary,            .         .         .  499 

,,       Urethral,           ...  629 

Calculus,  Cystic,  Examination  for,  626 

,,        in  Mare,  Removal  of,     .  626 

Callus,  Formation  and  Kinds  of,    .  80 

Cancer,  Black,  or  Melanosis,          .  423 

Epithelial,         ...  426 

,,       Examples  of,     .         ,         .  413 


726 


INDKX. 


421 

419 
420 
678 
383 
567 
566 
409-440 
312,  440 
264 
265 
371 
539 
607 
265 
144 
214 


587 
433 

352 

185 

297 
642 


Cancer — contin  ued. 

,,       Medullary,         .         ,         , 
,,       Scirrhous  or  Hard, 
,,       Soft,  .... 

Canine  Skin  Diseases,  Treatment  of. 
Canker,         ..... 
,,       External, 
,,       Internal,  or  Otorrhcea, 
Capped  Elbow, 
Capped  Hock, 
Capped  Knee, 

,,  Homed  Cattle  liable  to, 

Carbuncle  of  Coronary  Band, 
Cardiac  Stricture  of  (Esophagus,    . 
Caries  of  Teeth,    .... 
Carpitis  or  Inflammation  of  the  Knee, 
Carpus  in  Dogs,  Dislocation  of, 
Cartilage,  Morbid  Condition  of, 

,,         Eedfern,  Dr.,  on  Wounds  of,  219 
Cartilaginous  Degeneration  of  Arterial 
Coats, 
,,  Tumours, 

Case  of  Gelatinous  Degeneration  after 

Neurotomy,       .... 
Cases  of  Osteo-Porosis, 
Case  of  Subcutaneous  Laceration  of 

Flexor  Metatarsi, 
Castration,  .... 

, ,         Precautions  before  Operation,  642 
,,         Preparation  for  Operation,     643 
,,         Torsion,  Operation  by, 
,,         Operation   when    Hernia 

is  present, 
,,         Consequences  of, 
, ,         Inflammation  after, 
,,         Haemorrhage  after, 
, ,         Farcy,  Glanders,  and  Par- 
alysis after, 
,,         Tetanus,  Amaurosis,  Cham- 
pignon,  Scirrhus    of    the 
Cord  or  Sarcocele,  after, 
,,         Champignon,  Treatment  of,  650 
,,         D'Arboval  on  Champignon,   651 
,,         Chronic   Suppuration    or 

Fistula  of  Scrotum,     . 

,,         Peritonitis,   . 

, ,         Post  Mortem  of, 

•,,         Treatment  of, 

,,  Hernia  following, 

, ,         when  Hernia  is  present, 

Cat,  Mange  in,     . 

Cataract,       ..... 

,,        False  or  Spurious, 

,,         True,      .... 

Cattle,  Gut-Tie  in,        .         .         . 

Causes,  additional,  of  Lameness,    . 

,,     of  Anchylosis  of  Vertebrae, 

,,     of  Carbuncle  of  Coronary  Band,  372 

,,     of  False  Quarter,  and  Caution,    374 

„     of  Grease,  .         .         .         673 


644 

646 
647 
647 
648 

648 


649 


651 
652 
653 
654 
613 
646 
706 
560 
562 
661 
621 
240 
204 


Causes  of  Inflammation,         .         . 
of  Lymphangitis, 
of  Pain  in  Inflammation,     . 
of  Scrofulous  Synovitis, 
of  Sprain, 

of  Sprain  of  Flexor  Brachii, 
of  Sprain  of  Flexor  Tendons, 
of  Synovitis,  and  Symptoms 
of,  .         .    _      . 

Causticking  in  Bone-Spavin, 
Cautery,  Actual,   .... 

Cervical   Vertebrae,    Dislocation   of. 
Case  of,  .... 

Champignon  or  Scirrhous  Cord,  after 
Castration, 
,,  Treatment  of. 

Cherry's,  Mr.,  Remarks  on  Carpitis, 
Choking,        .  .  .  •         . 

Chorea,  Definition  of. 
Chronic  Inflammation,  Treatm  ent  of, 
,,      Scrofulous  Synovitis, 
,,      Suppuration, 
Clams  in  Treatment  of  Hernia, 
Clark,  Mr.  Bracy,  on  (Estrus  Bovis, 
Classification  of  Bones, 
,,  of  Joints, 

,,  of  Skin  Diseases, 

,,  of  Tumours, 

, ,  of  Wounds, 

Clipping  of  Horses, 
Coarse  Hocks,        .... 

Coccyx,  Fractures  of, 
Cold,  Effect  of,      . 
Comparison   between    Mucus,    Epi- 
thelium, and  Pus,       . 
Compound  Fractures, 

,,  Treatment  of. 

Concussion  of  the  Brain, 

,,  Fatal  Terminations  of, 

,,  Haemorrhage  in,  . 

,,  Post  Mortem  Appearances, 

,,  Professor  Syme  on  Tre- 

phining, 
Congenital  Hernia, 
Contact,  Mortification  by. 
Contused  and  Lacerated  Wounds, 
Consequences  of  Castration,  . 
Corns,   ...... 

Coronary  Band,  Carbuncle  of, 
Coronitis,  Inflammation  of  Coronary 
Substance,  .... 

Cough,  Dental,      .... 

Counter-irritation,  Theory  of, 
Cramp  in  Stifle,     .... 

Cranial  Bones,  Fractures  of,  • 

Crib-biters,  .... 

Cross  Lameness,    .... 

Crusta  Labialis,     .... 

,,       Petrosa  Tum-jurs, 
Curb,    ...  ... 


PAOZ 

14 

591 
19 
209 
241 
256 
274 


310 
323 

Ulj 

649 
650 
205 
530 
245 
76 
208 
651 
611 
711 
148 
203 
655 
408 
448 
663 
307 
122 
465 

39 

86 
86 
109 
110 
115 
112 

115 

608 
59 
455 
647 
381 
371 

370 
514 
319 
296 
104 
540 
233 
673 
4S5 
314 


INDEX. 


727 


Cystic  Calcuhis,  Examination  for, 
,,       Tumours,  various  kinds. 

Cysts,  Compound,  or  Proliferous, 
,,       Dentigerous, 
„       ISercus,  in  Horned  Cattle, 


PAGE 

626 
437 
443 
445 
441 


D'Arboval  on  Champignon,  .         651 

,,  on  Syphilis  in  Horse,     .  631 

Definition  and  Classification  of  Wounds,  448 


,,         of  Lameness, 

236 

Definitions  of  Inflammation,  . 

1 

Degeneration  of  Arterial  Coats, 

586 

•*       ,,           Gelatinous,  andliupturec 

L 

,,               Tendon,  Case  of,   . 

352 

Dental  Cough, 

514 

Dentition,  Diseases  during,    . 

513 

,,         Fever, 

515 

Deposits,  Urinal, 

623 

Depression,  Simple  Fracture  with. 

104 

Derma,  Disordered  Sensibility  of,  . 

682 

Dermatodectes  Bovis,    . 

694 

„             Equi,     . 

689 

,,             Ovis,      . 

696 

Dermatozoa, 

685 

Dermatophyta,      .... 

714 

Diagnosis  of  Lameness, 

231 

.,        of  Lameness,  Rules  for,  . 

239 

,,        of  Shoulder- Joint  Lameness 

254 

,,        of  Scrotal  Hernia,  . 

607 

,,        of  Splint  Lameness, 

158 

,,        and    Treatment    of    Bone 

Abscess, 

176 

Diagnostic  Signs  of  NaviciJar  Arthritis,  340 

Diathrodial  or  True  Joints, 

106 

Dick,  Professor,  on  Fistulous  Umbili- 

cal Hernia, 

599 

„               on  Foot-Rot, 

400 

,,               on  Laminitis, 

356 

,,               Treatment  of  Grease, 

676 

Diffuse  Phlebitis, 

573 

Dilatation  of  CEsophagus, 

538 

Diseases  of  Alveolar  Pi'ocesses, 

506 

,,        of  Arteries, 

578 

,,        of  Bladder, 

623 

,,        of  Bones, 

78 

,,        during  Dentition,     . 

513 

, ,        of  the  Ear, 

566 

, ,        of  External  Organs  of  Urina- 

tion,   .... 

623 

,,        of  External  Organs  of  Genera- 

tion,   .... 

630 

,,        of  Eyes,  .... 

542 

, ,        of  Facial  Region, 

493 

. ,        of  Facial  Sinuses, 

517 

of  Feet,  .... 

325 

,,        of  Ghding  Articulations  of 

Hocks, 

301 

,,        of  Head, 

566 

,,        of  Hock, 

299 

,,        of  Horn-secreting  Structures, 

370 

Diseases — continued. 

,,  of  Humours  of  Eye,  .  547 
,,  of  Joints,  and  Classification,  203 
,,  of  Lids  of  Eye,  .  .  549 
,,  of  Ligamentous  and  Ten- 
dinous Structure  of  Hock,  31 0 
,,  of  Lymphatics,  .  .  578 
, ,  of  Mammary  Gland,  .  636 
of  Mouth,  ...  493 
,,  of  Neck,  .  .  .  566 
,,  of  Nerves  of  Eye,  .  .  548 
,,  Non-Inflammatory,  of  Bone,  178 
,,  of  (Esophagus,  .  .  528 
,,  of  Pharynx,  .  .  .  528 
,,        of  Pyramidal  Process  of  Os 

Pedis,           .         .         .  328 
,.        of  Shoulder- Joint,    .         .  253 
,,        of  Skin,  ....  655 
,,        Skin,  due  to  Animal  Para- 
sites,    .         .         .         .  685 
,,        Skin,  due  to  Epizoa,          .  709 
,,        Skin,  due  to  Vegetable  Para- 
sites,            .         .         .  714 
,,        Skin,  Parasitic,         .         .  685 
-    ,,        of  Tongue,        ...  501 
,,        of  Vagina,        ,         .         .  636 
,,        of  Veins,          .         .         .  5QQ 
Dislocations,          .         .         .         .  142 
,,             of  Carpus  in  Dogs,     .  14.4 
,,             of   Cervical  Vertebrae, 

Case  of,         .         .  145 

,,             of  Eyeball,         ,          .  563 

,,             Partial,  of  Fetlock- Joint,  144 

Disordered  Sensibiuty  of  Derma,    .  682 

Dissecting  Aneurism,              .         .  684 

Distichiasis,  .         .         .         .         .  651 

Dog,  Mange  in,     .         .         .         -  699 

,,     Follicular  Scabies  in,     .         .  700 

Dropsy  of  Joints  (Hydrops  Articu- 

lorum),         .         .         .  227 

,,       of  Scrotum,       .         .         .  636 
Dupuytren's  *'  Stages  of  Repair"  of 

Bones,       .         .         .         ,         .  81 

Ecraseur,  The,      ....  530 

Ectropium,    .          .         .         .          .  549 

Eczema  Impetiginodes,  or  Pustulosum,  670 

,,       Mercuriale,        .          .         .  670 

,,       Rubrum,            .          .         .  669 

,,       Simplex,           .          .         .  668 

Eczema,  Various  Forms  of,             .  668 

Eczematous  Inflammation,               ,  667 

Elbow  Lameness,            ,         .         .  260 

Elephantiasis,        .         .         .         .  593 

,,             from  Grease,             .  673 

Enchrondomata,     or     Cartilaginous 

Tumours,           ....  433 

Entropium,             ,          ,         .         .  650 

Epidermic  Tumours,      .         .         .  430 

Epiphyses,  Separation  of,      .         .  ^1 


728 


INDEX. 


PAGE 

Epiplocele,             •         .         .         .  610 

Epithelial  Tumours,      .         .         .  430 

Epizoa, 709 

Epulis, 600 

Equine  Lymph,     .         .         .         .  671 
Erysipelas  after  Wounds,       .         .  484 
,,         (Edematous,           .         .  484 
,,         Phlegmonous,        .         .  485 
Erythema,             .         .         .         .  654 
,,         Mammilarum,       .         .  663 
Erythematous  Inflammation,           .  659 
Examination  for   Cystic   Calculus,  626 
of  Eye,     ...  663 
Exomphalos,           ....  597 
Extravasation,        ....  29 
Exudation  in  Inflammation,  .         .  3 
Eyes,  Diseases  of,           .         .         .  542 
,,     Traumatic   and   Simple  Oph- 
thalmia, Conjunctivitis,     .  542 
Treatment,            .         .         .  643 
Nebvda,  Albugo,  or  Leucoma,  544 
PercivaU  on,         .         .         .  545 
Staphyloma,          .         .         .  546 
Diseases  of  Humours  of.  Glau- 
coma,        ....  547 
Diseases  of  Nerves  of.  Amau- 
rosis, Gutta  Serena  or  Glass - 
Eye,           ....  548 
Strabismus,  Squinting,          .  549 
Abnormal  Position  and  Diseases 

of  Lids  of,  Ectropium,        .  649 

Wharton  Jones'  Treatment,  550 

Entropium,            .         .         .  550 

Trichiasis,  Distichiasis,         .  551 
Warts  on  Eyelids,  Wounds  of 
Eyelids,  Lachrymal  Fistula, 

Strictiu-e  of  Lachrymal  Duct,  552 
Parasites,  Mr.  Charles  PercivaU 

on,              ....  553 

Fungous  Haematodes,             .  554 
Periodic  Ophthalmia,  or  Moon- 

Blindness,  Symptoms,        .  555 
PercivaU  on,         .         .         .  556 
Cataract,               .         .         .  560 
PercivaU  on,         .         .         .  560 
True  Cataracts,     .         .         .  561 
Spurious  or  False  Cataracts,  562 
Dislocation  of  Eyeball,          .  563 
Eemoval  of  EyebaU,     .         .  663 
Examination  of  the  Eye,       .  663 
,,              by  Ophthalmo- 
scope, .         .  564 
Diseases  of  Humovu-s  of,        .  547 
Diseases  of  Lids  of,       .         .  549 
Diseases  of  Nerves  of,            .  648 
Examination  of,             .         .  663 
Method  of  returning,    .         .  663 
,,     Parasites  of,           .         .         .  653 
Kyfcl)all,  Dislocation  of,           .         .  563 
,,       Hemovalof,                •        .  663 


PAGE 

Eyelids,  Warts  on,         .        •        . 

552 

,,       Wounds  of, 

552 

Facial  Eegion 

Diseases  and  Injuries  of, 

493 

»> 

Diseases   of   Mouth, 
Tongue,    (Esopha- 

gus, &c. 

493 

59 

Tumour  of  the  Lip, 

493 

,9 

BruLses  of  the  Mouth, 

494 

y  9 

Severe  Bits,  . 

494 

tt 

Affections  of  the  Buccal 

Membrane, 

494 

>• 

Sporadic  Aphthae  or 

Thrush, 

495 

ff 

Paralysis  of  the  Lips, 

496 

ft 

Treatment, 

497 

)> 

Affections  of  Glands 

and  Ducts  of  Mouth, 

497 

>) 

Open  Parotid  Duct, 

497 

5  J 

Treatment, 

498 

5» 

Salivary  Calculi,     . 

499 

,9 

Excessive    Secretion 

of  Saliva,  Ranula, 

and  Epulis, 

500 

it 

Affections     of      the 

Tongue,  Glossitis, 

501 

»> 

Ulcers  of  Tongue,  Par- 
alysis     of     Tongue, 

Treatment, 

502 

9  J 

Deformities  of  Mouth, 

Irregularities  of  Teeth, 

Parrot  Mouth,     . 

504 

>> 

Diseases    of     Alveolar 

Processes, 

606 

}) 

Mr.  Vamell  on  Causes 

of,       .         .         . 

606 

It 

Caries  of  the  Teeth, 

507 

;> 

Mr.  Tomes  on, 

609 

>> 

Symptoms,     by    M. 

Bouley, 

611 

>> 

*'  Speculum  Oris," 

511 

J  t 

Diseases  occurring  dur- 

ing Dentition, 

513 

>> 

Dental  Cough, 

514 

)) 

Dentition  Fever  (Per- 

civaU), D' Arboval  on, 

515 

>» 

Supernumerary  Teeth, 

516 

>> 

Diseases  of  Facial  Sin- 

uses, 

517 

>> 

General  Symptoms, 

517 

J> 

Use  of  Trephine,     . 

518 

>t 

Setons  and  after  Treat- 

ment, 

521 

tt 

Professor  VameU's  Re- 

marks, 

523 

ft 

Nasal  Gleet, 

526 

>» 

Pharynx,    (JEsophagus, 

&c..  Diseases  of, 

528 

>> 

Post-Pharyngeal     Ab- 

scess, 

528 

INDEX. 


V29 


Facial  Region,  Diseases  and  Injiiries 

of— 

continued. 

„             Pus      in       Gutteral 

Pouches,  Treatment, 

529 

,,             Pharyngeal    Polypi, 

the  "Ecraseur," 

530 

„             Choking,  Per ci vail  on, 

530 

, ,             Gamgee  on  Causes  of. 

Cases  of, 

532 

,,             Treatment  of. 

534 

,,             Use  of  Probang,     . 

535 

,,             CEsophagotomy,  Car- 

bolised        Cat-Gut 

«     Sutvu-e, 

537 

,,             Dilatation  and  Stric- 

ture of  (Esophagus, 

538 

„             Case  by  Mr.  Cheetham 

,  538 

,,             Cardiac  Stricture  of 

Qllsophagus,  Perci- 

vall  on  Treatment, 

539 

,,             Crib-Biters  and  Wind- 

Suckers, 

540 

Facial  Sinuses,  Diseases  of. 

517 

False  Aneurisms, 

584 

False-Joints,          .... 

88 

Fetlock-Joint,  Partial  Dislocation  of, 

144 

False  Joints,  Treatment  of  ;  Syme's 

Treatment,         .... 

89 

False  Quarter,       .... 

373 

False  or  Spurious  Cataract,  . 

562 

Farcy  after  Castration, 

648 

Fatty  or  Atheromatous  Degeneration 

of  Arterial  Coats, 

587 

Fatty  Tumours,     .... 

431 

Favus  or  Honeycomb  Ring- Worm, 

714 

Febra  Pyogenica, 

48 

Feet,  Diseases  of,           ... 

325 

,,     Shoeing,  preliminary  Remarks 

upon,        .... 

325 

,,     Shoe  used  at  the  College, 

327 

„     Disease  of  the  Pyramidal  Pro- 

cess of  Os  Pedis, 

328 

,,     Ossification  of  Lateral  Carti- 

lages (or  Side-Bones), 

329 

,,     Treatment, 

331 

,,     Navicular  Arthritis    (vai-ious 

Theories  as  to), 

332 

, ,     Contractions  of  Foot  in, 

333 

,,     Sprain  or  Laceration  of  Fibres 

of  Perforans  in. 

335 

,,     Symptoms  of,       . 

339 

,,     Diagnostic  Signs  of. 

340 

,,     Pathology  of,       . 

342 

,,     Pointing,     .... 

347 

,,     Treatment,  Seton, 

349 

,,     Neurotomy, 

350 

.,     Unfavourable  Results  of  Neu- 

rotomy,   .... 

351 

,,     Case  of  Gelatinous  Degenera- 

tion and  Rupture  of  Tendon, 

352 

PAG  8 

Feet,  Diseases  of — continued. 

, ,     Appearance  of  Navicular  Bone 

in  the  same  Case,       .         .  235 
, ,     Pathological  Anatomy  of  Gela- 
tinous Degeneration  in  Man,  353 
,,     Extract   from   Spetice's    Lec- 
tures on,            .         .         .  353 
,,     Laminitis  or  Inflammation  of. 
Acute,        Subacute,        and 
Chronic,             .          .         .  356 
,,     Professor  Dick  on,        .         .  356 
,,     Pathology  of,       .         .          .  357 
,,     Symptoms  of,  in  both  Fore  Feet,  393 
,,     in  Hind  Feet,      ...  364 
,,     Treatment,  Mr.  Broad's  Treat- 
ment and  Shoe,          .         .  366 
,,     Diseases     of     Horn-secreting 

Structures,         .         .         .  370 
,,     Villitis,  Coronitis  (or  Inflam- 
mation of  Coronary  Substance),  370 

,,     Treatment,            .         .         .  370 

,,     Carbuncle  of  Coronary  Band,  371 

,,     due  to  what,  and  Treatment,  372 

,,     False-Quarter,      .         .         .  373 

.,,     Causes,  Treatment,  and  Caution,  374 

,,     Sand-Crack,          .         .         .  374 

,,     Treatment,            .         .         .  376 
,,     French  and  English  Operations  for,  377 

,,     Keratoma,  Treatment,          ,  378 

,,     Seedy-Toe,            .         .         .  380 

,,     Corns,          ....  381 

,,     Treatment,           .         .         .  382 

,,     Thrush,        ....  382 

,,     Canker,        ....  383 

,,     Treatmunt,           .          .         ,  384 

,,     Accidental  Injuries  to,           .  387 
,,     Pricks  in  Shoeing,  and  Gathered 

Nails,       ....  387 

,,     Detection  and  Treatment,    .  388 

,,     Caution  in  Paring,        .         .  389 

,,     Weak  Feet,          .         .         .  389 

,,     Quittor,       ....  389 
,,     Treatment,  Modes  of,  Bistouri 

Cache,      ....  390 

,,     Foul  in  the  Foot,          .         .  393 

,,     Foot-Rot  in  Sheep,       .         .  395 

,,     Mr.  Fleming  on,           .         .  395 

,,     Professor  Dick  on,        .         .  395 
,,     Difference  betw^een,  and  Foot- 

and-Mouth  Disease,           .  401 

Femur,  Fractures  of,              .          .  125 

Fetlock-Joint,  Sprain  of,        .         .  283 

Fever,  Dentition,           .         .         .  515 

,,       Inflammatory,    .          .         .  60 

Fibrous  Tumours,           .         .          .  429 

Fistula,  Lachrymal,       .         .         .  552 

,,       Salivary,           .         .         .  497 

Fistula  of  Scrotum,         .         .         .  651 

Fistulous  Umbilical  Hernia,            .  599 

„         Withers,         .           106,  118,  570 


730 


INDEX. 


PAGE 

Fleas,  Pulex  Irritans,    .         .         .  710 
Flexor  Brachii,  Sprain  of,       .         .  255 
,,       Metatarsi,    Subcutaneous  la- 
ceration of,      .         .         .  296 
, ,       Perf  orans  Tendon  liable  to  In- 
jury,      ....  315 
,,       Tendons,  Sprain  of,    .         .  273 

"Fly," 712 

Follicular  Scabies  in  Dogs,    .         .  700 
Foot,   Contraction  of,    in  Navicular 

Disease,     .....  333 

Foot-Kot,  Professor  Dick  on,          .  400 

Formation  of  Callus,      .         .         .  80 

,,         of  Pus,           ...  31 

,,         of  New  Vessels  (Virchow 

and  Paget),       .         .  27 

,,         of  Sinuses,     .         .         .  51 

Foul  in  tlie  foot,    ....  393 

Foetus  in  Utero,  Inguinal  Hernia  in,  608 

Fractures,     .         .         .         .         .  78 

,,         of  Anterior  Maxilla,        .  98 

,,         of  Bones  of  Knee,  .         .  135 

Modes  of,       .         .         .  78 

,,         Symptoms  of,          .          .  79 

.,         of  Back  during  Operations,  120 

ofCalcis,         ...  129 

of  Coccyx,      .         .      '   .  122 

,,         Compound,     .         .         .  86 

, ,         Compound,  of  Crest  of  Occiput,  108 

,,         of  Cranial  Bones,    .         .  104 

,,         of  Femur,       .         .         .  125 

,,         of  Frontal  Bone,     .         .  101 

,,         of  Humerus,  .         .          .  131 

,,         of  Antero-Iliac  Spine,     .  121 

,,         of  Iliac  Spine,liow  determined,  123 


of  Inferior  Maxilla,         .  91 
Treatment    of,    by  Mr. 

Walker's  Apparatus,    .  95 

of  Nasal  Bone,        .          .  98 

of  Metacarpi,          .         .  135 

of  Navicvdar,           .         .  137 

Non-union,  Causes  of,     .  88 

of  Olecranon,  tranversely,  133 

of  Os  Pedis,    .          .         .  139 

of  Particidar  Bones,         .  91 

ofPateUa,      ...  127 

of  Pelvis,        ...  122 

from  Pressure  of  Bit,       .  92 

from  Punching  out  Incisors,  93 

Punctured,     .          .          .  107 

of  Radius,      .         .         .  135 

of  Ramus  of  Lower  Jaw,  93 

of  Sacrum,     .         .         .  121 

of  Scapula,     .         .          .  131 

of  Sesamoids, .         .         .  135 

of  Suffraginis,         .         .  135 

of  Superior  Maxilla,         .  101 

through  Symphysis  Pubis,  125 

of  Tibia,          ...  128 

Treatment  of,          .         .  83 


Fractures — continued. 

,,         of  Trochanters,        .         .  126 

,,         of  Tuberosity  of  Ischium,  125 

,,         ofUhia,          ...  134 

,,         of  Vertebrae,  .         .         .  117 

Fragilitus  Ossium,          .         .         .  197 

Frontal  Bone,  Fracture  of,     .          .  101 

Fungus  of  the  Brain,     .         .         .  116 

Fungus  Hsematodes,      .         .         .  554 

Gamgee  on  Aneurism,  .         .         .  581 

Gastrocnemii,  Injiu-ies  to,       .         .  313 

Gathered  Nails,     ....  387 
Generation,    Diseases    of    External 

Organs  of,           ....  630 

Gerlach's  Classification  of  Parasites,  686 

Gerlach  on  Parasites,     .         .         .  691 

Girard  on  Inguinal  Hernia,    .         .  605 

Glands  of  Mouth,  Affections  of,      .  497 

Glanders  after  Castration,      .         .  648 
Grape  and  Small  Shot  Wounds,       460,  461 

Glass-Eye, 548 

Glaucoma,    .         .         .         .         .  547 
Glossitis,       .         .         .         .         .  601 
Goodsir,  Professor,  on  Morbid  Con- 
dition of  Cartilage,         .  215 
,,       on  Motion  of  Hock- Joint,  305 
Granulations,  Healing  by,      .         .  477 
Grease,          .         .         .         .         .  671 
,,       Causes  of,          .         .         .  673 
,,       Causing  Elephantiasis,        .  673 
,,        (Chronic),  Sarcoptes  Hippo- 

podus  in,         .         .         .  672 

,,       Treatment  of,   .         .          .  676 

Gun-Shot  Wounds,         ...  458 
,,             Progress,  if  favourable,  461 

Gutta  Serena  or  Glass-Eye,    .         .  548 

Gut-Tie  in  Cattle,          ...  621 

Guttural  Pouches,  Pus  in,      .         ,  529 

Haycock,  Mr.,  on  Lymphangitis,   .  590 

Head,  Neck,  Veins,  &c.,  Diseases  of,  566 

Ear,  Diseases  of,           .         .  566 

Internal  Canker,  or  Otorrhoea,  566 

Treatment,           .         .         .  6QQ 

External  Canker,          .         .  567 

PoU-Evil,    ....  568 

Treatment,  .         .         .         .  568 

Caused  by  Bearing-Rein,      .  569 

Fistulous  Withers,       .         .  570 
Jugular   Vein,   luSammation 

of  (Phlebitis),    ...  670 

Pathology  of,       .         .         .  570 

Treatment,           .         .         .  672 

Diffuse  Phlebitis,         .         .  573 

Thrombus,  .         .         .         .  574 

Varicose  Veins,   .         .         .  674 

Phlebolites  or  Vein  Stones, .  575 

Entrance  of  Air  into  Veins,  576 

Spence  on  Cause  of,      .         .  577 


INDEX. 


731 


Healing  by  Granulations,       .         .  477 

.,       by  Secondary  Adhesions,  .  480 
,,       of  Subcutaneous  and  Open 

Wounds,  difference  (Paget),  474 

,,       under  a  Scab,    .         .         .  481 

,,       Wounds,  Mode  of,     .         .  448 

Healthy  or  Laudable  Pus,      .         .  33 

Heat  in  Inflammation.  .         .         .  22 

Hectic  condition  in  Strangles,         .  44 
Hereditary  Tendency  in  Immobilite, 

Shivering,  &c.    .         .         .         .  248 

Herniaj,         .....  596 

,,       Reducible,         .         .          .  596 
, ,       Irreducible,    Strangulated, 

Exomphalos, .         .         .  597 

,,       Treatment  of  Exomphalos,  598 

,,       Fistulous  Umbilical,          .  599 

,,       Professor  Dick  on,    ,         ,  699 

,,       Mr.  Pattieon,           .         .  600 

,,       Ventral,    .         .         .         .  601 
,,       Case   of  Ventral  Artificial 

Anus  by  Mr.  Karkeek,  .  601 

,,       Simonds,  Pi-ofessor,on  Ventral,  602 

,,       Inguinal  or  Bubonocele,     .  602 

,,       Girard  on,         .         .          .  603 

,,       Peculiarities  of,         .         .  604 

,,       Symptoms  and  Treatment,  605 

,,       following  Castration,          .  613 

,,       Scrotal  or  Oscheocele,        .  606 

,,       Strangulation  in,       .         .  607 

,,       Diagnosis  of,     .         .         .  607 

,,       Morbid  consequences  of,    .  608 

,,       Congenital,       .          .         .  608 
, ,       Inguinal    in     "  Foetus     in 

Utero,"        ...  608 

,,       after  Birth  and  Causes,      .  609 

,,       Epiplocele,        .         .         .  610 
,,       Scrotal,    Operation    for,    in 

Stallions,       .         .         .  616 
,,       Simple,  Operation  for,       .  616 
,.       M.  Barry's  Method  oi  Operat- 
ing   615 

,,       Herniotomy,     .         .         .  611 

,,       Taxis  and  Clams  in,  .         .  612 
,,       Stanley,    Mr.,   on  Inguinal 

and  Scrotal,  .         .         .  613 
,,       Scrotal,  in  Pigs,         .         .  620 
„       Gut-Tie  in  Cattle  and  Treat- 
ment,   ....  621 
Hernia  Cerebri,    .          .          .          .  116 
,,       present,  Mode  of  Castration,  646 
Herniotomy,           .         .          .          .  611 

Herpes, 663 

,,       Circinatus  or  Vesicular  Eing- 

Worm,            .         .         .  664 
High-Heeled  Shoe  in  Injury  to  Flexor 

Perforans  Tendon,      .         .          ,  317 

Hip -Joint  Lameness,      .         .         .  291 

Hock,  Capped,      ....  312 

,,       Coarse,        ....  307 

„      Diseases  of,         .         .         .  299 


PAGE 

Hock,  Sprung,       .         .         .         .  301 
, ,      Diseases  of  Gliding  Articula- 
tions of,   .         .         .         .  301 
,,      Diseases  of  Ligamentous  and 

Tendinous  Structures  of,  .  310 

,,      Joint  Lameness,  True,         .  299 

, ,      most  susceptible  to  Bone-Spavin,  303 

Honeycomb  Ring- Worm,       .         .  714 

Horn-Secreting  Structures,  Diseases  of,  370 

Horses,  Clipping  of,       .         .         .  603 

Horse  or  Gelding,  Lithotomy  in,    .  627 

Humerus,  Fractures  of,           .         .  131 

Humid  Tetter,       ....  668 

Hydrocele  or  Dropsy  of  Scrotum,  .  636 

Hydrops  Articulorum,   .         .         .  227 

Haemorrhage  after  Castration,         .  648 

,,           in  Concussion  of  Brain,  115 

,,           in  Wounds,        .         .  449 


Immediate  Union  of  Wounds, 

476 

Iramobilitd,  ..... 

247 

Impairment  of  Function  in  Inflamma- 

mation,      ..... 

24 

Impetigo  Labialis  at  Facialis, 

673 

Incised  Wounds,  Haemorrhage, 

448 

Inferior  Maxilla,  Fracture  of, 

91 

Inflammation,        .... 

1 

, ,              Definitions  of, . 

1 

,,             Pathology  of,   . 

2 

,,             Exudation, 

3 

, ,              Phenomena  of, 

4 

,,              Stasis  in, 

9 

, ,             Parenchymatous    and 

Secretory, 

12 

,,             Virchow  on,     . 

12 

,,              Causes  of, 

14 

,,             Burdon  Sanderson  on, 

15 

,,              Varieties    of,    due   to 

Causation,     . 

16 

, ,              Local  Symptoms  of. 

18 

, ,              Redness, . 

18 

,.              Pain, 

19 

,,              Cause  of  Pain, 

21 

.,              Swelling, 

22 

',,             Heat,       . 

22 

,,              Impairment  of  Function 

24 

,,              Chronic,  . 

25 

, ,             Terminations  of. 

26 

,,             Resolution, 

26 

,,             Adhesion, 

27 

,,              Formation  of  New  Vessels 

» 

Virchow  and  Paget  on 

,  27 

,,             Blood      Effusion      or 

Extravasation, 

29 

,,              Suppuration    or   For- 

mation of  Pus, 

31 

,,             Virchow  on  Pus, 

32 

,,              Healthy  or  Laudable  Pus 

,33 

,,             Abscess, 

35 

,,             Acute,     . 

35 

„             Cold,        . 

35 

1700 


INDEX. 


Inflammation — continued. 
Chronic, 


35 

Diffuse  Suppuration,  36 
Superficial  Suppuration,  37 
Virchow  on,  .  .  38 
Mucus,  Epithelium, 
and  Pus,  Compari- 
son between,  .  39 
"White  Corpuscles,  .  41 
Pebra   Pyogenica,    or 

Strangles,     .         .  43 

Symptoms  of,  .         .  44 

Tracheotomy,   .         ,  46 

Hectic  condition,      .  47 

Pyaemia,  ...  48 

Pathology  of,  .         .  48 

Signs  and  Treatment  of,  49 

Peabsorption  of  Pus,  51 

Formation  of  Sinuses,  51 

Ulceration,       .         .  52 
Ulcers,  Varieties  and 

Treatment  of,       .  53 
IMortification,  or  Death 

of  a  part,     .         .  55 

"Varieties  of,     .         .  56 
Necrsemia,  or  Death  of 

the  Blood,     .         .  56 

Inflammatory,           .  58 

by  Contact,      .         ,  59 

Symptoms  of,  .         .  60 
Inflammatory    Fever, 

Professor  Miller  on,  61 
Types  of,  .  .  Q5 
Inflammatory  Appear- 
ances of  Blood,  ,  65 
Bufi^y  Coat,  .  .  66 
Treatment  of,  .  .  66 
Old  View  of,  .  .  68 
Blood-Letting  in,  .  68 
Dr.  Alison  on,  .  68 
Views  of  the  Modern 

School,         .         .  69 
Local     and     General 

Bleeding,      .         .  70 

Method  of  Bleeding,  70 

Second  Blood-Letting,  70 
Influences  opposed  to 

Blood-Letting,      .  71 

Use  of  Purgatives  in,  72 
Opium,  Aconite,  Anti- 
mony, and  Mercury 

in,_        .         .         .  73 

Alkaline  Remedies  in,  73 

Nitrate  of  Potash,    .  74 

Chronic,  Treatment  of,  76 

of  Bone,  .         .         .  151 

after  Castration,        .  647 

of  Coronary  Substance,  370 

Eczematous,      .         .  667 

Erythematous,          .  659 


Inflammation — continued. 

of  Feet,   ...  356 

of  Jugular  Vein,       .  570 

of  Knee,  or  Carpitis,  265 

of  Lymphatics,          .  589 

of  Mammary  Gland,  638 

of  Muscles,  or  Myositis,  249 

Squamous,  of  Skin,  .  679 

of  Synovial  Membranes,  206 

Traumatic,  of  Joints,  223 

of  Vagina,        .         •  636 

Inflammatory  Appearances  of  Blood,  65 

Fever,      .         .         .  608 

Fever,  Types  of,       .  64 

Mortification,  .         .  55 

Inguinal  Hernia  in  "  Foetus  in  Utero,"  608 

„              or  Bubonocele,     .  602 

Injuries,  Accidental,  to  Feet,          .  387 

,,       to  Arteries,       .         .         .  588 

,,       of  Facial  Region,       .         .  493 

,,       to  Gastrocnemii,        .         .  313 

Internal  Necrosis,  rare,           .         .  174 

Iodide  of  Arsenic,  Preparation  of,  .  680 

Irreducible  Hernia,        .         .         .  597 

Irrigation,  Method  of,  for  Open  Joint,  225 

Ischium,  Fractm-es  of  Tuberosity  of,  125 

Joints,  Diseases  of,  Classification  of,  203 
,,  Anchylosis  of  Vertebra,  .  203 
,,  Causes  of,  ...  204 
,,  Symptoms  obscure,  .  .  205 
,,  Treatment,  .  .  .  205 
, ,  Diathrodial,  or  True,  .  206 
,,  Inflammation  of  Synovial 
Membrane,  or  Acute  Syno- 
vitis, ....  206 
,,  Causes  and  Symptoms,  .  207 
,,  Treatment,  .  .  .  207 
, ,  Chronic  Scrofulous  Synovitis,  208 
,,       Pathological   Anatomy,  and 

Causes  of,        .         .         .  209 
,,       Calcification    of    Symovial 

Fringes, 210 

,,       Rheumatoid  Arthritis,        .  210 

,,       Symptoms,         .         .         .  211 

,,      Anatomical  Character  of,    .  212 

,,       Similar  to  Rheumatic  Gout,  212 

,,       Morbid  Condition  of  Cartilage,  214 

,,       Goodsir  on,         .         .         .  215 

,,       Dr.  Redfem's  Conclusions  on,  218 
, ,       Healing  of  Wounds  in  Articular 

CartOage,  Redfern,           .  219 
,,       Traumatic  Inflammation  of, 

or  Open  Joint,          .         .  223 

,,       Condition  of  Part,      .         .  224 

„       Treatment,         ...  224 

,,      Method  of  Irrigation,          .  225 
, ,       Dropsy  of  (Hydrops  Articulo- 

rum) — see  also  Lameness,  227 

,,       Stiffening  of,  or  Anchylosis,  228 


Joints,  Osseous  or  True,  Fibrous,  Liga- 
mentous, Spurious, 
,,       False,         .... 
Jugular  Vein,  Inflammation  of, 

Karkeek,    Mr.,  on  case  of  Ventral 

Artificial  Anus, 
Kennel  Lameness  in  Dogs,    . 
Keratoma,  .... 

Kinds  of  Anchylosis, 

,,     of  Splints,  .... 
Knee,  Fracture  of  Bones  of, 
Kummirree,  .... 

Labialis,  Crusta,    .... 
Lacerated  Contused  Wounds, 
Laceration   of   Perforans   Fibres   in 

Navicular  Disease,     . 
Laceration,  Subcutaneous,  of  Flexor 

Metatarsi,  .... 

Lachrymal  Duct,  Stricture  of, 

,,  Fistula  of,    . 

Lameness,    ..... 
Diagnosis  of. 
Manifestation  during  repose 

and  movement, 
Cross,   .... 
Definition  of, 
Pain  and   Weakness  are 

causes. 
Rules  for  Diagnosis  of,  . 
Other  Causes  of,    . 
Sprain  or  Strain,  . 
Causes  of,      . 
Treatment,   . 
Strain  of  Psoae  Muscles, 
Situation  of  them, 
Causes  of ,      . 
Treatment,   . 
Chorea,  Definition  of,    . 
Stringhalt,    . 
Sometimes  due  to  Mela- 
nosis, 
Immobility,    Shivering, 
Sprained  Back, 
Hereditary    tendency    to 

foregoing, 
Myositis,  or  Inflammation 
of  Muscular  Structure, 
Treatment,   . 
Rheumatic  Disease, 
Lameness  of.  Metastatic, 
Kennel  Lameness  in  Dogs, 
,,         Symptoms,    . 
,,         Treatment,   . 
Lamenesses,  Particular, 
,,  Shoulder, 

„  Disease     of     Shoulder 

Joint, 
„  Diagnosis, 


INDEX. 

733 

PAGE 

PAGE 

Lamenesses 

,  Particular — continued. 

228 

5  J 

Sprain  of  Flexor  Brachii 

255 

88 

)> 

Causes,  Result,  and  Treat 

- 

570 

ment. 

255 

>> 

Shoulder-Shp,    . 

256 

J> 

Why  most   in   Plough 

GOl 

Horses, 

257 

250 

>J 

Symptoms, 

258 

378 

5> 

Treatment, 

259 

228 

J> 

Wasted  Shoulders,    an 

156 

Unsoundness  in  Law, 

259 

135 

5  > 

Elbow  Lameness, 

26-) 

554 

55 

Diagnostic  Signs  of,  . 

261 

>> 

Olecranon  wounded  in 

673 

Hunting,         Curious 

456 

Symptoms, 

261 

J) 

Sprain    of     Radial    or 

335 

Superior  Carpal  Liga- 

ment, 

262 

296 

55 

Capped  Knee,    . 

264 

552 

J  > 

Horned  Cattle  liable  to. 

265 

552 

5  5 

Carpitis,  or  Inflamma- 

231 

tion  of  Knee, 

265 

231 

55 

Mr.  Cheriy's  Remarks, 

265 

5  5 

Speedy  Cut, 

269 

233 

5  5 

Symptoms  of,    . 

269 

230 

9  J 

Prevention  and  Treat- 

230 

ment  of, 

270 

3  5 

Broken  Knees, 

270 

237 

5  5 

Sprain   of    the   Flexor 

239 

Tendons, 

273 

240 

5  5 

Causes, 

274 

241 

55 

Symptoms  and  Treat- 

241 

ment, 

275 

242 

55 

Tenotomy, 

276 

242 

5  5 

Sprain    of    Suspensory 

242 

Ligament, 

278 

243 

55 

Percivall  on  the  Liga- 

244 

ment, 

278 

245 

55 

Special  Treatment,     . 

283 

246 

5  5 

Sprain  of  Fetlock-Joint, 

283 

5  » 

Sesamoiditis, 

284 

246 

5  5 

Pathology  and  Symptoms 

284 

5  5 

Ring-Bones,  Kinds  of. 

285 

247 

J  ) 

Treatment, 

289 

J  5 

in  Posterior  Extremities, 

291 

248 

5  > 

Hip-Joint, 

291 

5  5 

Hip  Joint,  Symptoms  of 

249 

and  Treatment, 

293 

250 

55 

Sprain  and  Atrophy  of 

250 

Crural  Muscles, 

294 

251 

5  5 

Stifle-joint, 

294 

250 

55 

Stifle  subject  to  Cramp, 

296 

250 

J> 

Subcutaneous    Lacera- 

251 

tion  of  Flexor  Meta- 

253 

tarsi  Muscle, 

296 

253 

5  5 

Case  of  it. 

297 

5  J 

Diseases  of  Hock,  True 

253 

Hock-Joint,    . 

299 

254 

J> 

Bog-Spavin, 

299 

734 


INDEX. 


Ijamenesses,  Particular — continued, 

,,           Blood -Spavin,    .         .  301 
,,           Diseases  of  the  Gliding 
Articulations   of   the 
Hocks,  Bone  Spavin, 

Definition,      .         .  301 

„  •         Percivall's  Theory,     .  303 
,,           Porm   of    Hock    most 

susceptible,     .         .  304 
„           Goodsir  on  Motion  of 

Hock-Joint,    *        .  305 

,,           Coarse  Hocks,  .         .  307 

,,           Pathology  of  Bone-Spavin,  307 

,,           Causticking  in,  .         .  310 
,,           Diseases  of  the   Liga- 
mentous   and     Ten- 
dinous Structures  of 

Hock,  Thorough-Pin,  310 

,,           Treatment,         .         .  311 

,,            Capped  Hock,   .         .  312 

,,           Injuries  to  Gastrocnemii,  313 

,,           Curb,         .         .         .  314 

,,           Treatment,         .          .  315 
,,           Tendon  of  Plexor  Per- 

forans  Kable  to  Injury,  315 
,,            Treatment    of,    High- 
heeled  Shoe,  .         .  317 
„           Theory  of  Counter-Irri- 
tation,  .         .         .  319 
,,           Treatment  of.  Dr.  Ben- 
nett on  Counter-Irri- 
tation,   ...  320 
.,           Pubefacients  and  Blisters,  321 
,,           Hints  on  Blistering  gene- 
rally,     .         .         .  322 
,,           Actual  Cautery,          .  323 
,,            Setons,      .         .         .  324 
Lameness,  Kennel,  in  Dogs,           .  250 
,,           Splint,       .         .          .  158 
Laminitis,  or  Inflammation  of  Peet, 

Kinds  of, 356 

Laudable  Pus,       ....  33 

Lawson's,  Mr.,  Treatment  of  Tetanus,  491 

Leucoma,      .....  545 
Tjeucocytes,  Wandering,  in  Inflammation,  41 

Lice, 709 

Lichen,          .          .          .         .          .  670 
Liston's,  Mr.,  Theory  on  Concussion 

of  the  Brain,      ....  112 

Lip,  Tumour  of,    .          .          .          .  493 

Lipomata,  or  Patty  Tumours,          .  431 

Lips,  Paralysis  of,          ...  496 

Lithotomy  in  Horse  or  Gelding,     .  627 

,,          in  Ox,           .         .         .  629 

Lower  Jaw,  Fracture  of  Ramus  of,  93 

Luxations,    .         .          .         .         .  142 

of  Patella,    .         .         .  142 

Lymphangitis  or  Weed,          .         .  689 

Lymj^hatics,  Diseases  of,        .          .  579 

,,           Inflammation  of,         .  589 


PAGB 

M'Gillivray,  Mr.,  on  Ring- Worm,  721 

Maggots, 712 

Mallenders, 679 

Mammary  Gland,  Diseases  of,        .  636 
Mammilarum,  Erythema,       .         .  663 
Mammitis  or  Inflammation  of  Mam- 
mary gland,        .         .         .         .  638 
Mange  in  Cat,       ....  706 
,,      in  Dog,      ....  699 
,,      in  Horse,  ....  685 
,,       in  Ox,        ....  694 
„      in  Pig,       ....  699 
Manifestations  of  Lameness,  .         .  233 
Mare,  Removal  of  Calculus  in,        .  626 
Melanosis,    .....  423 
,,         causing  Stringhalt,         .  246 
,,         Development  of,    .         .  424 
Mercury  on  Bone,  Effects  of,  by  Pro- 
fessor Bennett,     .         .  200 
,,         in  Inflammation,      .         .  73 
,,         in  Osteo-Sarcoma,    .         .  184 
Mercurial  Poisoning  in  Sheep,        .  708 
Metacarpi,  Fractures  of,         .         .  135 
Method  of  Bleeding,      ...  70 
,,       of  returning  Eye,      .         .  563 
Microscopic  Characters  of  new  Bone,  83 
Miller,  Professor,   on  Inflammatory 

Fever,         .....  61 
Modern  School  Views  on  Blood -Letting,  69 

Modes  of  Fracture  of  Bones,           .  78 

,,       of  Union  of  Bones,      .         .  79 

Morbid  Condition  of  Cartilage,       .  214 

,,       Consequences  of  Scrotal  Hernia,  G08 

Mortification,         .         .         .         .  55 

,,             Varieties  of,     .         .  5Q 

,,             by  contact,       .          .  59 

,,              Inflammatory,           .  58 

Mouth,  Bruises  of,         .         .         .  494 

,,       Deformities  of,           .          .  504 

,,       Diseases  of,        .         .          .  493 

,,       Glands  and  Ducts,  Aft'ections  of ,  49/ 

Parrot,      .          .          .          .  504 

Moon  Blindness,  ....  555 

Mucous  Cysts  and  Bronchocele,     .  442 
Mucus,  Epithelium,  and  Pus,  Com- 
parison of, 
Mud-Fever,  . 
Muscle,  Subcutaneous  Laceration  of 

Flexor  Metatarsi, 
Musket -Shot  Wounds,  . 
Myositis  or  Inflammation  of  Muscu 
lar  Structure,     . 


39 

6^0 

296 
459 

249 


Nasal  Bone,  Fracture  of,        .         .  98 

,,      Gleet,          ....  517 

„      Polypus,      .          .         .          .  428 

Navicular  Arthritis  (various  Theories),   332 

,,         Bone,  Fracture  of,          .  137 

Nebula, 544 

Necrosed  Bone,  Removal  of,  .         .  97 


INDEX. 


35 


PAGE 

Neck,  Diseases  of,  .         ,         .  566 

Necrosis,       .         .         .         .         .  155 

,,         Interna],  rare,  .         .  174 

Nerves  of  Eye,  Diseases  of,   .         .  548 

Nettle-Eash,  ....  665 

Neuromatous  Tumours,  .  .  432 

Neurotomy  in  Navicular  Arthritis,  351 

,,  Unfavourable  Kesults  of,  351 

New  Bone,  Microscopic  Characters  of,  J 

Non- Inflammatory  Bone  Diseases,  1/ 

Non-Union  of  Fracture,  Causes  of,  i 


Occiput,  Compound  Fracture  of  Crest  of,  108 
Old  View  of  Treatment  of  Inflammation,  68 


Olecranon,  Fractures  of, 

^ 

133 

,,          Wounded    in     Huntir 

ig. 

Curious  Symptoms, 

261 

Open  Joint,  .... 

223 

Operations,  French  and  English,  : 

[or 

Sand-Crack, 

377 

,,           for    Scrotal    Hernia 

in 

Stallions, 

611 

,,           for  Simple  Hernia, 

602 

,,           by  Torsion, 

606 

Opium  in  Inflammation, 

73 

Ophthalmia,  Periodic  or  Specific, 

555 

, ,           Simple  or  Traumatic, 

542 

Ophthalmoscope,  The,    . 

564 

Oscheocele,   .... 

606 

Osseous  Tumours, 

436 

Ossification  of  Lateral  Cartilages, 

or 

Side- Bones, 

329 

Osteo -Porosis, 

184 

Osteo-Sarcoma,      ... 

199,  436 

Osteoid  Tumours, . 

436 

Ostitis,           .... 

151 

,,       and  Periostitis  of  Metacar 

pi,      153 

,,       Scrofulous, 

160 

Otorrhoea,     .... 

566 

Over-Beach, 

462 

Ox,  Lithotomy  in, 

629 

,,    Mange  in,       . 

694 

Ozoena,           .... 

517 

G^sophagotomy,    . 

536 

(Esophagus,  Cardiac  Stricture  of, 

539 

,,           Dilatation  of. 

538 

,,           Diseases  of. 

528 

,,           Stricture  of, 

538 

(Estridia,       .         .         .         .         . 

711 

CEstrus  Bovis,        .         .          .          . 

711 

Paget  on  Formation  of  New  Vesse 

Is,        27 

,,      on  Healing  of  Wounds, 

473 

,,      on  Inflammation, 

3 

,,      on  Tumours, 

409 

Pain  causing  Lameness, 

236 

,,     in  Inflammation,  . 

19 

Paralysis  after  Castration, 

648 

,,         of  Lips,  . 

496 

J,         ofTongup,      . 

502 

PAGE 

Paraphymosis,  and  Treatment,  .  632 
Parasites,  Animal,  .  .  .  685 
Skin  Diseases  due  to,  685 


,,         Classified  by  Gerlach,    .  685 

of  Eye,           ...  553 
,,         Vegetable,  Skin  Diseases 

due  to,  .  .  .  714 
Parasitic  Skin  Diseases,  .  .  685 
Parenchymatous  and  Secretory  In- 
flammation, .  .  .  .  12 
Paring,  Caution  in,  .  .  .  389 
Parotid  Duct,  Open,  .  .  .  497 
Parrot- Mouth,  .  .  .  .  504 
Patella,  Fractures  of,  .  .  .  127 
,,  Luxation  of,  .  .  .  142 
Pattie,  Mr.,  on  Herniae,  .  600 
Pathological  Anatomy  of  Gelatinous 

Degeneration  in  Man,  353 
,,           Anatomy  of  Scrofulous 

Synovitis,        .         .  209 

Pathology  of  Bone-Spavin,     .          .  307 

,,         of  Favus,       .          .          .  715 

,,         of  Inflammation,   .          ,  2 

,,         of  Laminitis,          .          .  357 

,,         of  Navicular  Arthritis,  .  342 

,,         of  Necrosis,  .         .         .  169 

,,         of  Scrofulous  Ostitis,      .  162 

,,         of  Phlebitis,           .          .  570 

, ,         of  Pyaemia,  ...  48 
,,         and   Symptoms   of   Sesa- 

moiditis,  .         .         .  284 

Peculiarities  of  Inguinal  Hernia,    .  604 
Pedal  Bone,   Disease  of  Pyramidal 

process  of,     .         ,  328 

,,             Fracture  of,     .          .  139 

Pelvis,  Fractures  of,      .         .          .  122 

Penis,  Amputation  of,  .         .         .  635 

Percivall  on  Bone-Spavin,      .         .  303 

,,         on  Choking,    .          .          .  530 

,,         on  Suspensory  Ligament,  278 

Periosteotomy,  Subcutaneous,         .  159 

Peritonitis, 652 

Persian  Insect  Powder,           .         .  710 

Pharyngeal  Polypi,        .          .         .  530 

Pharynx,  Diseases  of,    .          .          .  328 

Phenomena  of  Inflammation,          .  4 

Phlebitis, 570 

,,         Difl^use,          ...  572 

Phlebolites,  or  Vein  Stones,  .         .  575 

Phthiriasis  Equi,  ....  709 
Phymosis,  Percivall  and  D'Arboval 

on, 632 

Pig,  Mange  in,      .         .         .         .  699 

,,    Scrotal  Hernia  in,           .         .  620 

Pityriasis,     .         .          .         .          .  681 
Plough- Horses,  why  most  subject  to 

Shoulder-Slip,    ....  257 

Pointing  in  Navicular  Arthritis,     .  347 

Poisoned  Wounds,          .         .         .  468 

Poll-Evil, 568 


736 


INDEX. 


PAGE 

Polypi, 4'J8 

„       Nasal,       ....  428 

,,       Pharyngeal,       .         .         .  530 

Post  Mortem,  after  Peritonitis,         .  653 

Posterior  Extremities,  Lamenesses  of,  291 

Potash,  Nitrate  of,  in  Inflammation,  74 

Poultry  Lousiness,         .         .         .  709 

Pricks  in  Shoeing,          .         .         .  387 

Piobang,  Use  of,  .         .         .         ,  535 

Precautions  before  Castration,         ,  642 

Preparation  for  Castration,    .         .  643 

Prevention  of  Speedy-Cut,     .         ,  270 

Primary  Adhesion  of  Wounds,        .  477 

Prurigo,  or  Pruritis,      .         .         .  682 

Pruritis, 682 

Psoriasis,       .         .         .         .          .  679 

Psose  Muscles,  Situation  of,  .         .  242 

„     Strain  of,      .         .         .         .  242 

Pulex  Irritans,       .          .          .          ,  710 

Punctm-ed  Fracture,      .          .          .  107 

Wound,        ...  452 

Purgatives  in  Inflammation,            .  72 

Pus,  Formation  of,         .          .         .  31 

,,    in  Guttural  Pouches,      .          .  529 

,,    Reabsorption  of,    .         .         .  51 

Pustulosvim,  Eczema,     .         .         .  670 

Pyro-Punctvire,     ....  159 

Pyaemia,        .....  48 

,,         Pathology  of,            .         .  48 

Quitter, 389 

Rachitis, 179 

Radial  Ligament,  Sprain  of,  .         .  262 

Radius,  Fractures  of,     .         .         .  135 

Ranula,         .....  500 

Reabsorption  of  Pus,     ...  51 
Redfe-n,  Dr.,  on  Morbid  Condition 

of  Cartilage,          .  218 
„             on  Wounds  in  Carti- 
lage,   .         .         .  219 
Redness  in  Inflammation,       .         .  18 
Reducible  Hernia,          .         .         .  596 
Removal  of  Calciilus  in  Mare,         .  626 
„        ofEyebaU,      ...  563 
,,        of  Sabulous  Matter,          .  630 
Repair  and  Methods  of  Healing  of 

Wounds,    .....  473 

Resolution,   .....  26 
Results  of  Neiirotomy,  when  unfav- 

oiirable,          .         .         .  351 

,,       of  Sprain  of  Flexor  Brachii,  255 

of  Wounds,        .         .         .  484 

Rheumatic  Disease,        .         .         .  235 

Rheumatoid  Arthritis,  .         .         .  210 

,,  ,,         Anatomical 

Character  of,  212 
,,                   ,,         and  Gout  com- 
pared,    .  212 
Ribs,  Broken,        .         .         .         .  140 


Rickets, 

,,        Cause  of, 

, ,        Rokitansky  on, 

, ,        Treatment  of,  . 
Ring-Bones, 

,,  Kinds  of,  . 

Ring- Worm, 
Rokitansky  on  Osteo-Porosis, 

,,  on  Rickets, 

Rubefacients, 
Rules  for  Diagnosis  of  Lameness, 

Sabulous  Matter,  Removal  of. 
Sacrum,  Fractvires  of,    . 
Saliva,  Excessive  Secretion  of. 
Salivary  Calculi,    . 

,,        Fistula,  . 
Sallenders,    . 
Sand -Crack, 

Sarcocele  after  Castration, 
Sarcomatous  or  Solid  Tumour, 
Sarcoptes  Canis,    . 

,,         Cati, 

,,         Equi,     . 

,,         Hippopodus    in    Chronic 
Grease, 

,,         Hominis,  or  Acarus  Scabie, 

,,         Ovis,      . 

,,  Suis, 
Scab  in  Sheep, 
Scabies, 

Scapula,  Fractures  of,    . 
Scirrhus,  or  Hard  Cancer, 
Scrofulous  Ostitis, 

,,  ,,       Causes  of, 

Scrotal  Hernia,  Oscheocele, 
,,  in  Pigs, 

,,  in  Stallions,  Oper 

tion  for, 
Scrotum,  Fistula  of, 
Seedy-Toe,    . 
Setons, 

,,      in  Navicular  Arthritis 
Sesamoids,  Fractures  of, 
Sesaraoiditis, 
Severe  Bits,  . 

Sheep  Ointments  dangerous, 
Sheep,  Scab  in,     . 
Shivering,     . 
Shoe  used  at  College,     . 
Shoeing,  Preliminary  Remarks  upon, 

,,         Pricks  in, 
Shoulder-Joint,  Disease  of, 
, ,         Lameness, 
Slip, 
Side-Bones,  . 

Signs,  Diagnostic,  of  Elbovir  Lameness, 
Simonds,  Professor,  on  Ventral  Hernia,  602 
Simple  Fissure,      .         .         .         .  105 

Simple  Hernia,  Operation  for,        .         602 


INDEX. 


737 


PAGB 

Simple  or  Traumatic  Ophthalmia,  .  542 

Sinuses,  Formation  of,  .         .          •  51 

Sitfasts, 684 

Skin,  JJir^eases  of,  .  .  .  655 
,,  Classification  of,  .  .  655 
,,  by  Dr.  Bennett,  .  .  656 
,,  by  Dr.  Buchanan,  .  .  657 
,,  Erythematous  Inflammation,  659 
,,  Erythema,  .  .  .  659 
,,  'Mud-Fever,'  ...  660 
,,  Mr.  Broad's  Treatment  of,  .  661 
,,  Treatment  of  Erythema,  .  662 
,,  Clipping  of  Horses,  .  .  663 
,,  Erythema  Mammilarum,  .  663 
,,  Herpes,  .  .  .  663 
,,  Circinatus  or  Vesicular  Ring- 
Worm,  ....  664 
,,  Urticaria,  Nettle-Rash,  Surfeit,  665 
,,  Eczematous  Inflammation,  .  667 
,,  Eczema,  Various  forms  of,  .  668 
,,  Simplex  or  Humid  Tetter,  .  668 
,,  Rubrum,  ....  669 
,,  Mercuriale,  .  .  .  670 
,,  Lichen,  ....  670 
, ,     Eczema  Impetiginodes,  or  Pus- 

tulosum,           .          .          .  670 

,,     Wilson  on,            .          .          .  670 

,,     Grease,         ....  671 

,.     Equine  Lymph,              .         .  671 
, ,     Sarcoptes  Hippopodus  in  Chronic 

Grease,  .  .  .  672 
,,  Elephantiasis  from  Grease,  .  673 
,,  Causes  of  Grease,  .  .  673 
,,  Impetigo  Labialis  et  FaciaHs,  673 
,,  Crusta  Labialis,  .  .  673 
,,  Treatment  of  Eczematous  Erup- 
tion, ....  674 
,,     Professor  Dick's  Treatment  of 

Grease,   ...         -  676 

,,     Treatment  of  Grease,    .         .  676 
, ,     Treatment  of  Grease  by  actual 

Cautery,           ...  676 

,,     Treatment  of  Chronic  Eczema,  677 

,,     Squamous  Inflammation,       .  679 

,,     Psoriasis,     .         .         .         .  679 

,,     Mallenders  and  Sallenders,  .  679 

,,     Treatment  of  Psoriasis,          .  680 

,,     Iodide  of  Arsenic,  Preparation  of,  680 

,,     Pityriasis,    .         .         .         .  681 

,,     Treatment  of,       .         .         .  682 

,,     Disordered  Sensibility  of  Derma,  682 

,,     Prurigo,  or  Pruritis,     .         .  682 

,,     Acne,  or  Warbles,        .         .  683 

,,     Sitfasts,  Treatment  of,           .  684 

,,     Parasitic,     .         .         .         .  685 
,,     Due  to   Animal  Parasites  or 

Dermatozoa,  Scabies,        .  685 

, ,     Species  of  Parasites,  after  Gerlach,  685 
,,     Sarcoptes     Hominis     (Acarus 

Scabie),            .         .         .  686 

3 


Skin,  Diseases  of — continued. 

,,     Bourguignon  on,  . 

,,     Sarcoptes  Equi, 

,,     Dermatodectes  Equi, 

,,      Symbiotes  Equi, 

,,     Gerlach  on  Parasites, 

,,     Mange  in  the  Ox, 

,,     Symptoms  in  the  Ox, 

,,     Scab  in  Sheep, 

,,     Dermatodectes  Ovis, 

,,     Sarcoptes  Ovis,     . 

,,     Mange  in  Pig  (Sarcoptes  Sui 

,,  ,,     in  Dog  (Sarcoptes  C 

, ,     Follicular  Scabies  in  Dog, 

,,     Mr.  Fleming  on, 

,,     Mr.  Hunting  on, 

,,     Mange  in  Cat  (Sarcoptes  Cati), 

,,     Treatment  of  Scabies, 

,,     Stavesacre,  Experiments  mth, 

,,     Sheep  Ointments  dangerous, 

, ,     Due  to  Epizoa, 

,,     Lice,  .... 

,,     Poultry  Lousiness  (Phthiriasis 
Equi),     . 

,,     Bouley  on,  . 

,,     Fleas  (Pulex  Irritans), 

,,     Persian  Insect  Powder, 

,,     Ticks, 

,,     Other  Animal  Parasites 

,,     Botflies  (ffistridia), 

.,     CEstrus  Bovis, 

,,     Bracy  Clark  on  Q^]strus  Bovis, 

,,     Maggots,  or  the  "Fly," 

,,     Due  to  Vegetable  Parasites, 

,,     Favus   or    Honeycomb   Ring- 
Worm,  Pathology  of, 

,,     Symptoms,  Bennett  on, 

,,     Treatment, 

,,     Tinea  Tonsurans,  or  Ring-Worm,  719 

,,     Aitken  and  Lowe  on  Pathology  of,  720 

,,     Mr.  M'GilUvray  on  Ring-Worm,  721 

,,     Treatment  of  Ring- Worm,    .         721 
Snakes,  Poison  of,  .         .         .  469 

Sore  Shins,  ....         153 

,,     Symptoms  of,  .         .         .         154 

Spavin,  Bog  and  Blood,  .         .         299 

Bone,        ....  301 

Specific  Ophthalmia,       .         .         .  555 

"Speculum  Oris,"  The,  .         .         511 

Speedy-Cut,  ....  269 

Spence,  Professor,  on  Aneurism,    .         581 

,,        on  Cause  of  Air  in  Veins,  577 

,,        on  Gelatinous  Degeneration,      353 
Spent-Balls,  Wounds  from,    .         .  45(5 

Splints, 155 

Block  Tm,         ...  85 

for  Fractures,  Kinds  of,     .  84 

Kinds  of,  .         .         •         .         156 
Lameness,  Diagnosis  of,     .  153 

when  producing  Lameness,  157 

B 


686 
688 
689 
690 
691 
694 
695 
696 
696 
699 
s\  699 
aiiis),  699 
700 
701 
701 
706 
706 
707 
708 
709 
709 

709 
709 
710 
710 
710 
711 
711. 
711 
711 
712 
714 

714 
717 
718 


738 


INDEX. 


PA6K 

PAGE 

Splints,  Treatment  for, 

158 

Sympt( 

)ms  of  Fracture  of  Bones,     . 

79 

Split  Pastern,         .... 

136 

!           " 

of  Hip -.Joint  Lameness, 

293 

Sprain  or  Strain, 

241 

1 

1           >> 

of  Inflammation, 

60 

,,     of  Fetlock- Joint, 

283 

j> 

of  Inguinal  Hernia, 

605 

,,     of  Flexor  Brachii, 

255 

>> 

of  Kennel  Lameness, 

250 

,,     of  Flexor  Tendons, 

273 

j> 

Local,  of  Inflammation, 

18 

,,     of  Perforans  Fibres  in  Naviculai 

>> 

of  Laminitis, 

363 

Disease, 

335 

5  J 

of  Mange, 

686 

,,     of  Radial  or  Supero-Carpal  Liga 

J> 

of  Navicular  Ai'thritis, 

339 

ment,      .... 

262 

)  > 

of  Rheumatoid  Arthritis, 

211 

,,     of  Suspensory  Ligament, 

278 

J5 

Curious,  of  Wounded  Ole- 

Sprained Back,      .... 

242 

cranon, 

261 

Squamous  Inflammation  of  Skin,    . 

679 

>  J 

of  Scabies,     . 

686 

Squinting,     ..... 

549 

J> 

of  Shoulder-Slij^,  . 

258 

Stallions,  Operation  for  Scrotal  Hernia 

b 

J5 

of  Speedy-Cut, 

269 

in,               ..... 

611 

J  J 

of  Sore  Shins, 

154 

Stanley,  ISIr.,   on  Inguinal  and  Scrota 

L 

}> 

of  Sprain  of  Flexor  Tendons 

,275 

Hernia,      ..... 

613 

>> 

of  Strangles, 

44 

Staphyloma,           .... 

546 

>> 

of  Tetanus,  . 

488 

Stasis,            ..... 

9 

>> 

TJnpropitious,  in  Compounc 

L 

Stavesacre,  Experiments  with, 

707 

Fractures, 

86 

Stifle- Joint  Lameness, 

294 

?> 

of  Urethritis, 

631 

,,     Subject  to  Cramp, 

296 

Synovitis,  Acute, 

206 

Strabismus,            .... 

549 

,,^ 

Chronic  Scrofulous, 

208 

Strain,           

241 

Sjmovial  Fringes,  Calcification  of. 

210 

,,     of  Psoae  Muscles, 

242 

Strangles,               .... 

43 

Taxis, 

>....« 

612 

,,         Hectic  Condition, 

44 

Teeth, 

Caries  of,   .... 

507 

,,         Symptoms  of. 

44 

5  > 

[rregularities  of, 

504 

,,         Tracheotomy  in, 

46 

5> 

rumours,    .... 

445 

Strangulated  Hernia,     . 

597 

Tenotomy,     ..... 

276 

Strangulation  in  Scrotal  Hernia,     . 

607 

Terminations  of  Inflammation, 

31 

Stricture,  Cardiac,  of  Qi^sophagus, 

539 

Tetanus 

5, 

486 

,,         of  Lachiymal  Duct, 

552 

5> 

after  Castration, 

649 

,,         of  CEsophagus, 

539 

J5 

from   Fracture   of    Frontal 

Stringhalt,    ..... 

246 

Bone,    .... 

102 

Structure  of  Tumours, 

408 

Tetter, 

Humid,     .... 

668 

Subcutaneous  Periosteotomy, 

159 

Theory 

of  Counter-Irritation, 

319 

Subperiosteal  Suppuration, 

175 

ThoroUj 

?h-Pin,        .... 

310 

Suffraginis,  Fracttires  of. 

135 

Thrombus, 

574 

Supero-Carpal  Ligament,  Sprain  of. 

262 

Thrush 

382 

Superior  Maxilla,  Fracture  of, 

101 

Tibia,  Fractures  of,        .         .         . 

116 

Suppuration,  Chronic,    . 

651 

Ticks, 

710 

,,           Diffuse,     . 

36 

Tinea  Tonsurans,  or  Ring-Worm,  . 

719 

, ,            Subperiosteal, 

175 

Tongue 

,  Affections  of,   . 

501 

,,            Superficial, 

37 

}> 

Diseases  of,       . 

423 

Surfeit,          ..... 

665 

>> 

Paralysis  of,     . 

502 

Suspensory  Ligament,  Sprain  of,   . 

278 

5  J 

Ulcers  of,          .          .         . 

502 

Suture,  CarboUsed  Cat-Gut,  . 

537 

Torsion 

.... 

644 

,,       Varieties  of,      . 

450 

Tracheotomy,        .... 

46 

Swelling  in  Inflammation, 

22 

Traumatic  Inflammation  of  Joints, 

223 

Symbiotes  Equi,    .... 

690 

Tread, 

463 

Syrae,    Professor,     on    Caries    and 

Treatment  of  Aneurism, 

583 

Ulceration,    . 

165 

,, 

of  Burns,       .          .    ■     . 

467 

, ,     on  Trephining  for  Concussion 

, , 

of  Canine  Skin  Diseases, 

678 

of  the  Brain, 

115 

f  y 

of  Canker, 

384 

, ,     Treatment  of  False  Joints,      . 

89 

y  J 

of  Champignon,     . 

650 

Symphysis  Pubis,  Fracture  through. 

125 

)f 

of  Chronic  Eczema, 

677 

Symptoms  of  Anchylosis  of  Vertebrae, 

205 

>> 

Constitutional,  of  Wounds, 

452 

,,         of  Favus, 

717 

»> 

of  Eczematous  Eruptions, 

674 

INDEX. 


739 


PAGE 

Treatment  of  Erythema, 

662 

y  9 

of  Exomphalos, 

598 

of  Favus, 

718 

J  y 

of  Fracture  of  Frontal  Bone 

89 

y  J 

of  Grease, 

677 

y  y 

of  Inflammation,  . 

66 

y  y 

of  Inguinal  Hernia, 

611 

y  y 

of  Laminitis — Mr  Broad's 

Shoe, 

367 

J> 

of  Lymphangitis, 

592 

y  y 

of  Mammitis, 

640 

y  y 

of  Open-Joint, 

224 

y  y 

of  Peritonitis, 

654 

y  y 

of  Phlebitis,  . 

572 

>J 

of  Pityriasis, 

682 

9  5 

of  Psoriasis,  . 

680 

J  J 

of  Quittor,    . 

390 

y  y 

of  Ring-Bones, 

289 

yy 

of  Ping-Worm, 

721 

J  y 

of  Sand-Crack, 

376 

99 

of  Scabies,    . 

706 

J  J 

of  Side-Bones, 

331 

55 

and  Signs  of  Pyaemia,    . 

50 

5  y 

of  Sitfasts,    , 

684 

55 

Special,  of  Spi-ain  of  Sus- 

pensory Ligament,    . 

283 

59 

of  Splint,      . 

159 

59 

of  Tetanus,    . 

489 

95 

of  Ulcers, 

53 

Trephine,  Use  of, 

511 

Trephming,   . 

107 

55 

for  Cysts,     . 

444 

Trichiasis,     . 

551 

Trochanters,  Fractm-es  of, 

126 

True  Cataract, 

561 

,,     Joints, 

206 

Tmnour  of  Lip,     . 

493 

Tumours, 

408 

55 

Structure  and  Classification, 

408 

59 

Paget  on,         .         .         . 

409 

55 

Examples  of  Cancer, 

413 

99 

Scirrhus,  or  Hard  Cancer, 

419 

55 

Soft  Cancer,    . 

420 

99 

Medullary  Cancer, 

421 

55 

Melanosis,  or  Black  Cancer, 

423 

59 

Development  of. 

424 

9) 

Epithelial  Cancer,    . 

426 

5» 

Benign  or  Simple,   . 

427 

59 

Sarcomatous  or  Solid, 

427 

55 

Polypi    (Class   of    Fibrous 

Tumours),    . 

428 

55 

Nasal  Polypus,  and  Treat- 

ment, 

428 

99 

Epidermic   and   Epithelial 

Warts, 

430 

99 

Lipomata  or  Fatt}'-, 

431 

99 

Neuromatous, 

432 

55 

Enchondromata  or  Cartila- 

ginous, 

433 

99 

Crusta-Petrosa, 

. 

435 

PAGB 

Tumours — continued. 

,,         Calcareous,             ^         .  436 

,,         Osseous,         .         .         .  436 

,,         Osteoid  (Osteo -Sarcoma),  436 

,,          Cystic  (various  kinds),    .  437 
,,         Serous  Cysts,  Capped  Elbow,  437 

,,         Capped  Hock,        .         .  440 
,,          Serous  Cysts   in   Horned 

Cattle,       .          •         .  442 
,,         Mucous  Cysts  and  Bron- 

chocele,      .         .         .  442 
,,          Proliferous    Cysts,    Cyst- 
bearing     Cysts,     Cysts 

bearing  Hair  and  Skin,  443 

,,         Dentigerous  Cysts,         .  445 

, ,          Cysts,  Trephining  for,    .  447 

,,         in  Vagina,     .          .         .  638 

Types  of  Inflammatory  Fever,        .  64 

Ulceration,            .         .         .         .  53 
,,         and  Caries,  Syme  on,    .  165 
Ulcers,          .....  53 
„       of  Tongue,          ...  502 
Ulna,  Fractures  of,        .          .         .  134 
Umbilical  Hernia,  Fistulous,          .  599 
Union  of  Bone,  Modes  of,      .          .  79 
Unsoundness,  Wasted  Shoulders  an,  259 
Urachus,  Pervious         .         .         .  163 
Urethral  Calculi,            ...  629 
Urethritis,  Symptoms  and  Treatment,  631 
Urinal  Deposits,    ■         .          .          .  623 
,,              Causes  and  Symp- 
toms of,  .         .  625 
Urination,  Diseases  of  External  Or- 
gans of,              .         .         .         .  623 
Urine,  Analysis  of,        .         .         .  587 
Urticaria,                .         .          .          .  665 

Vamell,     Professor,     on    Causes   of 

,.  Diseases  of  Alveolar  Processes,  506 

,,         on  Diseases  of  Facial  Sinuses,  517 
,,         Treatment  of  Fracture  of 

Lower  Jaw,          .         .  95 
,,         Treatment  of  Fracture  of 

Nasal  Bone,         .          .  99 

,,         on  Osteo-Porosis,     .          .  189 

Vagina,  Diseases  of,       .          .          .  636 

,,        Tumours  in,      .          .          .  638 

Vaginitis,  or  Inflammation  of  Vagina,   636 

Varicose  Aneurism,        .          .         .  585 

,,         Veins,     ....  574 

Varieties  of  Mortification,      .         .  55 

,,         of  Tetanus,     ...  487 

Various  Forms  of  Eczema,      .         .  663 

Varix,  Aneux'ismal,        .          .         .  58o 

Veins,  Diseases  of,          .          .         .  506 

,,       Entrance  of  Air  into,           .  576 

Vein-Stones,          .          .          .         .  575 

Veins,  Varicose,             .         .         .  574 

Ventral  Hernia,     .         .         .         .  601 


740 


INDEX. 


Vertebrse,  Anchylosis  of, 

, ,         Fractures  of, 
Vesicular  Seminalis,  Distension  of, 
Vesicular  King-Worm,  . 

Vimtis, 

Virchow  on  Formation  of  New  Vessels, 

,,        on  Inflammation, 

,,        on  Pus,   .... 

, ,        on  Superficial  Suppuration, 

,,        on  Thrombosis, 

Walker,  Mr.,  Cradle  for  Broken  Jaw, 

Warbles, 

Warts,  .         .         .         .         . 

,,       on  Eyelids, 

Wasps  and  Bees,  Stings  of,    . 

Wasted  Shoulders  an  Unsoundness 
in  Law,      ..... 

Weak  Feet,  .... 

Weakness  causing  Lameness, 

Weed  or  Lymphangitis, 

White  Corpuscles  in  Inflammation, 

Wilson  on  Eczema  Impetiginodes, 

Wind -Suckers,       .... 

Withers,  Fistulae  of,       . 

Wounds,        ..... 
, ,         Definition,  Classification  of, 

and  Modes  of  Healing, 
, ,  ]  ncised,  Haemorrhage  in, 

,,         Varieties  of  Sutures, 
,,         ConstitiTtional  Treatment, 
,,         Punctured, 
,,         Contused  and  Lacerated, 
,,         Lacerated  Contused, 
,,         Gun-Shot, 
,,         From  Spent  Balls,  . 


PAGE 

PAGE 

203 

Wounds — continued. 

117 

,,         Musket-Shot, 

459 

631 

,,         Grape- Shot,    . 

460 

664 

„         SmaU-Shot,     . 

461 

370 

,,         Gun-Shot,  Progress  and  Con- 

27 

,,              sequences  if  favourable. 

461 

12 

,,         Treatment, 

462 

32 

,,         Burns,  Scalds,  and  the  Effect 

38 

of  Cold,      . 

465 

580 

,,         Treatment, 

, ,         Poisoned,  Stings  of  Wasps  and 

467 

95 

Bees,  Poisons  of  Snakes, 

468 

683 

,,         Over-Reach,     Tread,    and 

430 

Speedy-Cut, 

462 

552 

,,         Brushing  or  Cutting, 

463 

468 

, ,         of  Abdominal  Parietes,    , 
,,         Repair  of,  and  Methods  of 

463 

259 

HeaHng,    . 

473 

389 

,,         Paget  on. 

473 

237 

,,          Difference  between  Subcutan 

- 

589 

eous  and  Open,  from  Paget 

474 

41 

,,          Immediate  Union,  . 

476 

670 

,,         Primary  Adhesion, 

477 

540 

,,          Healing  by  Granulations, 

477 

570 

, ,          Secondary  Adhesion, 

480 

448 

,,         Under  a  Scab, 

481 

,,         Results  of,       . 

484 

448 

,,          Erysipelas,  (Edematous, 

484 

448 

,,          Phlegmonous, 

485 

450 

,,         Treatment, 

486 

452 

,,         Tetanus, 

486 

452 

,,          Varieties  of,    . 

487 

455 

,,         Symptoms, 

488 

456 

,,         Treatment, 

489 

458 

,,         Mr.  Lawson's, 

491 

459 

Wounds  of  Eyelids, 

552 

EDINBURGH:    PKINTEI)  BY  BUKNESS  AND  COMPANY,  PRINTERS  TO  HER  MAJESTY. 


Webster  Family  Libraiy  oi  Veterinary  Medicine 
Cummings  School  of  Veterinary  m^iomat 
Tufts  University 
200  Westboro  Road 
Nortli  Grafton,  MA  01536 


